2003 Volume 42 Issue 4 Pages 281-287
Objective: Vaginal cancer is a rare from of neoplasia. We studied cytologic and colposcopic findings and clinical features of vaginalintraepithelial neoplasia (VaIN) thought to be a preprecursor of vaginal cancer.
Study Design: Subjects were 20 cases of VaIN (VaIN I=16, VaIN II=1, VaIN III=3) entered in this study from 1989 to 2001. Clinical features, cytopathologic and colposcopic findings, and cytologic diagnosis of humanpapilloma virus (HPV) infection were studied.
Results: Patients were 28 to 75 years of age (average: 56 years). Hysterectomy was previously done in 13 for myoma (n=6), cervical cancer (n=5), and ovarian cancer (n=2). The lesion was in the upper third of the vagina in all cases. Colposcopic findings were white epithelium or punctuation, but no mosaicism was observed. Cytologic diagnosis of HPV infection (koilocytosis) was detected in 11 of the 20 (55%). Two patients with VaIN III underwent vaginectomy or radiotherapy and the other 18 were followed up without definitive treatment. No progressive disease was noted in those followed up.
Conclusion: Risk factors for VaIN are prior cervical intraepithelial neoplasia (CIN), previous hysterectomy, and HPV infection. Close observation of the lower genital tract, including the vagina, is necessary for diagnosing VaIN.
