Neoplastic lesions of the vaginal epithelium

1. Big picture

Neoplastic lesions of the vaginal epithelium are uncommon, but they are exam-important because they are closely related to human papillomavirus (HPV) disease, cervical/vulvar intraepithelial lesions, and postcoital or postmenopausal bleeding.

The key clinical rule:

Vaginal lesion or abnormal bleeding
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Do not assume it is primary vaginal disease
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First exclude cervical, vulvar, endometrial, and metastatic disease
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Confirm diagnosis by biopsy
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Stage and treat according to invasion, size, location, and spread

Most malignant vaginal tumours are not primary vaginal cancers. They are more commonly due to direct spread from cervix/vulva/endometrium or metastasis. True primary vaginal cancer is rare.

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