Adenosis is replaced by squamous metaplasia, which occurs naturally, and requires follow-up but not removal. Gallup DG, Talledo OE, Shah KJ, et al. Primary invasive vaginal carcinoma. Perez CA, Camel HM, Galakatos AE, et al. Primary invasive squamous carcinoma of the vagina.
Cervical biopsies are mandatory to rule out carcinoma of the cervix.
Carcinoma of the vulva should also be ruled out. The lymphatics may drain to pelvic or inguinal nodes or both, depending on tumor location, and consideration should be given to these areas in treatment planning. The proximity of the vagina to the bladder or rectum limits treatment options and increases complications involving these organs. For carcinoma of the vagina in its early stages, standard treatment applied by gynecologic oncologists or radiation oncologists is highly effective. III and IVA disease, radiation therapy alone is standard.