or dysplasia . Eventually it will invade the vaginal wall. With time, the tumor can extend directly to the tissue surrounding the vagina, the pelvic walls, the bladder or the rectum. ( See "Cancers of Female Pelvic Organs" .)
Lymphatic invasion and metastases is another avenue of spread. Carcinomas arising in the upper vagina can spread to the pelvic lymph nodes , and those in the lower vagina can spread to the lymph nodes in the groin.
Adenocarcinomas spread in a similar fashion, but they may have a higher incidence of metastases to the pelvic lymph nodes.
What Causes It The human papilloma virus (HPV), a sexually transmitted virus responsible for genital warts, is believed to cause vaginal intraepithelial neoplasia and invasive squamous cell carcinoma of the vagina. The time from infection to the development of an invasive cancer is thought to be from 5 to 10 years.
Most cases of adenocarcinoma of the vagina used to be associated with exposure to diethylstilbestrol (DES) in embryonic life. DES was given in the 1950s to women who were thought to be at risk for a miscarriage. The incidence of DES-related adenocarcinoma is highest for those women who were exposed during the first three months of their mother's pregnancy. The peak incidence is between age 17 and 21. The incidence of this disease peaked in the early 1970s and is now uncommon, since DES use during pregnancy fell out of favor during the 1960s and was banned in the early 1970s.
What causes the other vaginal malignancies is not clear.
