Introduction to vaginal tumors
Vaginal tumors can be divided into benign tumors and malignant tumors. Benign tumors of the vagina include fibroids, leiomyoma, hemangioma, lipoma, neuroma, myxoma, and papilloma. The name of the vaginal benign tumor generally does not produce obvious symptoms. Vaginal malignancy refers to a lesion in which malignant tumors occur in the tissues of the vaginal wall. There are primary and secondary ones. Secondary secondary metastasis from cervical cancer, vulvar cancer, endometrial cancer, rectal cancer, etc.; primary vaginal malignant tumors are rare, accounting for about 2% of gynecological malignancies.basic knowledge
The proportion of sickness: 0.01%-0.05%
Susceptible people: people who are not treated in time for gynecological inflammation
Mode of infection: non-infectious
Complications: vaginal malignancy
Cause of vaginal tumor
Cause of primary vaginal tumor
1. Chronic stimulation: Primary vaginal squamous cell carcinoma often occurs in the posterior hole, which may be related to the long-term use of pessary, vaginal leukoplakia or local inflammatory stimuli in patients with uterine prolapse.
2, pelvic radiation therapy: more than 20% of patients with primary vaginal cancer have a history of pelvic radiation therapy. It is generally believed that vaginal cell dysplasia or vaginal cancer can occur 10 to 40 years after cervical cancer radiotherapy. Women with pelvic radiation therapy under 40 years of age have a higher incidence of vaginal cancer.
3. Viral infection: Human papilloma, especially type 16 and 18 may be considered a promoter of vaginal malignancy.
4. Immunosuppression: For patients with congenital or acquired acquired and artificial immunosuppression, the incidence of cancer is higher. Vaginal cancer is no exception, and its incidence is higher in immunosuppressed patients.
5. Estrogen deficiency: Vaginal squamous cell carcinoma occurs in elderly women, may be associated with low levels of estrogen after menopause, leading to atrophy of vaginal mucosa epithelium, creating favorable conditions for carcinogenic factors.
6. Recently, vaginal clear cell adenocarcinoma is associated with endogenous estrogen.
7. It is speculated that vaginal endodermal sinus tumor may be a tissue conductor lacking embryos during the determined phase of germ cell migration, resulting in a dislocation of germ cells into the upper vaginal segment.
Dissemination and metastasis of vaginal malignant tumors: The lymphatic vessels and blood vessels of the vaginal mucosa are extremely rich, and the connective tissue under the mucosa is loose. This structure leads to the metastasis of vaginal cancer mainly by lymphatic metastasis and direct infiltration of adjacent organs and tissues.
1. Lymphatic metastasis: According to the anatomical part of the vaginal 1/3 of the lymphatic drainage into the pelvic lymph nodes, the lower third drainage of the inguinal lymph nodes, the middle third of which can be introduced into the pelvic lymph nodes, and can be introduced into the inguinal lymph nodes. Therefore, depending on the location of the vaginal cancer, the lymphatic metastasis is different.
2, direct infiltration: vaginal anterior wall cancer can involve the urethra and bladder; posterior wall cancer can involve the rectum or rectal tissue; sidewall lesions often invade the vagina; upper 1/3 and lower 1/3 lesions can be involved Cervical and vulva.
3, blood transfer: often occurs in advanced cases.
Vaginal tumor prevention
1. Actively treat diseases such as vaginal leukoplakia, chronic inflammation and ulcers.
2, where there are irregular vaginal bleeding, vaginal discharge abnormalities, early diagnosis and active treatment.
3, after vaginal cancer treatment should adhere to 3 to 6 months of review, should be cytological examination, recurrence of vaginal bleeding or vaginal discharge should be treated at any time.
Vaginal tumor complications Complications vaginal malignancy
1. Vaginal fibroids: mainly derived from the elastic fibers contained in the connective tissue of the vaginal wall. Such tumors are rare, often single growth, hard, pedunculated, basal activity, inconspicuous envelope, and more often on the vaginal wall. The tumor is small and has no obvious harm. When it is enlarged, it may cause a vaginal fall or a sexy discomfort.
2, neurofibromatosis: mainly from nerve sheath cells. The tumor is located under the vaginal mucosa and has multiple nodules of varying sizes. The boundary is unclear and the touch is soft and elastic. Generally asymptomatic, occasionally larger, the harm is generally: can cause vaginal discomfort or difficulty in sexual intercourse.
3, vaginal leiomyomas: mainly from the vaginal wall muscle tissue or vascular wall muscle tissue. Myocytes are abnormally hyperproliferative and form a mass. There is no obvious harm in the small fibroids, and the harm is increased when there is an increase: vaginal swelling, sexual intercourse and so on.
4, papilloma: a benign mucosal lesion. The clinical manifestations are diverse, and may appear as small, flat, filamentous, papillary or lumps in the vaginal mucosa, and may also be cauliflower-like. Hazard: Patients may also have increased vaginal discharge, itching of the genitals, occasional bleeding after sexual intercourse, and regular follow-up after treatment to prevent recurrence or malignant sex.
Vaginal tumor symptoms common symptoms interstitial bleeding vaginal blood secretions vaginal irregular bleeding leucorrhea black
1, vaginal bleeding. More manifested as contact bleeding, usually after sexual intercourse, or the use of equipment and postmenopausal.
2, vaginal discharge. Abnormal drainage is mainly related to tumor necrotic tissue and infection. The discharged body can be watery, and there may be rice soup, or mixed with blood.
3, oppression symptoms. When the advanced tumor compresses adjacent organs, corresponding compression symptoms may occur. Such as compression of the bladder, urethra, urgency, frequent urination, hematuria; when the rectum is oppressed, there may be difficulty in defecation, urgency and weight; late patients may also have blood in the stool, the tumor penetrates the rectal symptoms.
Irregular vaginal bleeding, bleeding after sexual intercourse and postmenopausal bleeding; increased vaginal discharge, even vaginal watery, bloody secretions with stench; with the development of the disease can occur waist, abdominal pain, dysfunction (including frequent urination, hematuria, dysuria And blood in the stool, constipation, etc.; severe cases can form vaginal fistula or rectal vaginal fistula; advanced patients may have renal dysfunction, anemia and other secondary symptoms, such as lung metastases can occur cough, venous blood, superficial lymph node metastasis can be reached Swollen lymph nodes, etc. Local lesions of the vagina are most common in papillary or cauliflower type, followed by ulcerated or infiltrating type.
Examination of vaginal tumors
Pelvic and vaginal B-ultrasound, vaginal cytology, vaginal pathogen examination, blood routine examination
Diagnosis and diagnosis of vaginal tumor
Early symptoms can be asymptomatic, and later symptoms are vaginal bleeding and abnormal vaginal discharge. Pain usually occurs in the late stages of cancer. The cancer in the lower part of the vagina may have early bladder irritation; the diagnosis of vaginal cancer is basically the same as that of cervical cancer, including careful speculum examination, vaginal cytology, and biopsy.
Speculum examination or palpation, visible vaginal wall with nodules, cauliflower-like, ulcers or local hardening, advanced cancer filled the vaginal cavity, and a large number of odor secretions. In addition, cancers that occur in the lower third of the vagina, often accompanied by inguinal lymph node metastasis, may detect swollen lymph nodes, hard, and even fusion or rupture.
In the triad, in addition to examining the local lesions, attention should also be paid to the elasticity of the entire vaginal mucosa and whether the paravaginal tissue is involved.