Vagina

Abstract

The majority of intraoperative consultations related to vaginal samples are to check adequacy of resection of tumors. Primary vaginal malignancies are rare; most of the intraoperative consults are for metastatic tumors that are responsible for 80% of all vaginal malignancies. Approximately a third of the metastases are of cervical origin, a fifth from the endometrium, and the remainder originates from other sites, particularly ovary, breast, and kidney. They spread to the vagina by direct extension from surrounding organs, or via lymphatic and blood vessels, most frequently involving the posterior wall of the upper third. Occasionally, pathologists are asked to identify vaginal lesions detected incidentally during other procedures or to rule out metastases. Portions of the vagina may also be included in radical resections for malignancies in other parts of the genital tract, and these will be considered with their corresponding organs (Chaps. 4–6). The present discussion will focus on lesions that primarily involve the vagina.