Vaginal tumor

Ultrasonography and CT have only a hmited role in detecting recurrent or residual vaginal tumor because they rely on the configuration of the lesion as the only criterion. The sensitivity of bofli modaUties is too low for differentiation of tumor from posttherapeutic changes and for the detection of small tumors. The accuracy of the cHnical examination is also limited, in particular when postoperative scar tissue is present. 

Toremifene is an estrogen receptor antagonist. The pharmacokinetics of toremifene are best described by a two-compartment model, with an a half-life of 4 hours and an elimination half-life of 5 days. Peak plasma concentrations are achieved approximately 3 hours after an oral dose. Toremifene is metabolized extensively, with metabolites found primarily in the feces. Toremifene is used for the treatment of metastatic breast cancer in postmenopausal women with estrogen-receptor-positive or unknown tumors. Toremifene causes hot flashes, vaginal bleeding, thromboembolism, and visual acuity changes. 

In women with lower-genital-tract carcinomas—cervical, vaginal, and vulvar carcinomas—hematogenous metastases are rarely present at diagnosis, and thus disease can frequently be controlled with local treatment. Small tumors can usually be treated with surgery alone, but cancers that penetrate deeply, particularly those that involve adjacent... 

Vaginal cancers are so similar to cervical cancers with respect to epidemiology, behavior, and treatment response that many clinicians have chosen to treat vaginal cancers of stage II or greater with chemoradiation on the basis of results from cervical cancer trials. Unfortunately, only scattered published reports of chemoradiation are available for this rare tumor. 

These drugs are contraindicated in patients with thrombophlebitis, thromboembolic phenomena, and cardiovascular and cerebrovascular disorders or a past history of these conditions. They should not be used to treat vaginal bleeding when the cause is unknown. They should be avoided in patients with known or suspected tumors of the breast or other estrogen-dependent neoplasms. Since these preparations have caused aggravation of preexisting disorders, they should be avoided or used with caution in patients with liver disease, asthma, eczema, migraine, diabetes, hypertension, optic neuritis, retrobulbar neuritis, or convulsive disorders. 

When tamoxifen 20 mg/day was compared with equieffective doses of anastrozole in 668 patients with advanced breast tumors that were hormone receptorpositive or of unknown receptor status, tamoxifen produced too high a rate of thromboembolism and vaginal bleeding to be considered the treatment of choice (51,52). 

Contrary to cancer treatment, cervicovaginal cancers are linked to vaginal pessary use. Review of cancer cases found that tumors occurred at sites of ring insertion. Although chemical carcinogenesis cannot be ruled out, chronic local infection may be the main... 

Okada, H. Sakura, R. Kawaji, H. Yashiki, T. Mima, H. Regression of rat mammary tumors by a potent luteinizing hormone-releasing hormone analogue (leuprolide) administered vaginally. Cancer Res. 1983, 43, 1869-1874. 

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