Primary adenocarcinoma of the vagina

The characteristics and treatment of eight patients with primary adenocarcinoma of the vagina were reviewed. Cytologic smears of the vagina aided in the diagnosis of adenocarcinoma but, less often, detected vaginal adenosis. Good correlation existed between the degree of differentiation of the primary tumor and the tendency toward lymphatic spread. The clinical stage, size of the primary lesion, presence and duration of symptoms and lymphangiographic findings were not helpful in this regard. Pretreatment lymphadenectomy as a basis for operative staging demonstrated the critical importance of the status of the lymph nodes in the planning of therapy and determination of prognosis. Vaginal reconstruction and ovarian preservation facilitated rehabilitation.