[Interdisciplinary S2k guidelines on the diagnosis and treatment of vaginal carcinoma and its precursors-recommendations on surgical pathology for histopathological workup, diagnostics, and reporting]
- PMID: 33346872
- DOI: 10.1007/s00292-020-00876-8
[Interdisciplinary S2k guidelines on the diagnosis and treatment of vaginal carcinoma and its precursors-recommendations on surgical pathology for histopathological workup, diagnostics, and reporting]
Abstract
Primary vaginal carcinoma is rare. There are two pathogenetic pathways, one associated with HPV high-risk infection and another one with inactivation of p53. Vaginal Paget's disease is rare and mostly associated with vulvar disease or represents intravaginal spread of associated locoregional cancer. Diagnostic vaginal biopsies should be examined by step sections on H&E. Sentinel lymph nodes should be processed completely using ultrastaging. Morphology-based prognostic factors with good clinical evidence are tumour stage and lymph node status. Molecular markers are not currently relevant for treatment decision and prognosis.
Das Vaginalkarzinom ist ein seltenes Malignom des weiblichen Genitales. Pathogenetisch können ein HPV-high-risk-Pathogeneseweg und ein p53-abhängiger Pathogeneseweg definiert werden. Der vaginale M. Paget ist selten und zumeist assoziiert mit einem M. Paget der Vulva oder lokoregionären Karzinomen. Diagnostische Biopsien sollen in Stufenschnitten aufgearbeitet werden. Sentinel-Lymphknoten sollen vollständig und mittels Ultrastaging untersucht werden. Etablierte morphologische Prognosefaktoren sind das Tumorstadium und lokoregionäre Metastasen. Molekulare Marker spielen derzeit keine Rolle.
Keywords: Cancer; Diagnostic; Guidelines; Histopathology; Prognosis; Staging; Treatment; VaIN; Vagina; WHO; Workup.
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