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Vaginal cancer

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Malignant tumours of the vagina

Malignant tumours of the vagina are cancerous growths that have the potential to spread (metastasize) to other parts of the body. Primary vaginal cancer is not common, accounting for only 1–2% of all female genital cancers. Most cancers of the vagina (80–90%) start in other organs (most often the cervix or vulva) and spread to the vagina.

Squamous cell carcinoma

Squamous cell carcinoma is the most common type of vaginal cancer. It begins in the squamous cells that make up the epithelial lining of the vagina.

  • makes up about 80–90% of vaginal cancers
  • occurs most often in women age 60 and older
    • About 10% of women are less than 40 years of age.
  • more likely to occur in the upper area of the vagina near the cervix
  • develops slowly – can take many years
    • It starts with precancerous changes in the epithelium called vaginal intraepithelial neoplasia (VAIN).
    • The precancerous changes may then develop into cancer.

Verrucous carcinoma is a rare distinct type of squamous cell carcinoma. It may recur locally after surgery but rarely metastasizes.


Adenocarcinoma begins in the glandular cells of the vagina.

  • makes up about 5–10% of vaginal cancers
  • occurs most often in women age 50 and older

Clear cell adenocarcinoma is a type of adenocarcinoma that occurs most often in women 15 to 22 years of age whose mothers took diethylstilbestrol (DES) before they were born. The risk appears to be greatest in women whose mothers took DES during the first 16 weeks of pregnancy.

Vaginal adenosis is a condition in which areas of glandular cells have replaced the squamous cells that normally line the vagina. It is found in nearly all women who were exposed to DES before birth and in approximately 40% of women not exposed to DES. It may occur at the same time as clear cell carcinoma, but it rarely progresses to adenocarcinoma.


Melanoma begins in the pigment-producing cells of the vagina called melanocytes.

  • makes up about 3–5% of vaginal cancers
  • average age of 55 years at time of diagnosis
  • most often begins in the lower third and front wall of the vagina
  • varies in size, colour and growth patterns


Sarcoma begins in the muscle or connective tissue cells of the vagina.

  • makes up about 3–4% of vaginal cancers
  • occurs most often in women age 50 and older
  • occurs deep in the walls of the vagina where the connective tissue and muscle are found

Leiomyosarcoma accounts for two-thirds of vaginal sarcomas. Other types include endometrial stromal sarcoma and malignant mixed Müllerian tumours.

Embryonal rhabdomyosarcoma (sarcoma botryoides) is a vaginal sarcoma most often found in children up to 6 years of age. It is rarely found in adults.


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