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Gestational trophoblastic disease
Clinical case A 32-year-old G1P0 at 9 weeks and 3 days gestational age by last menstrual period presents with new onset vaginal bleeding. A transvaginal ultrasound shows no embryo, but notes a complex, echogenic intrauterine mass containing many small cystic…
Other rare vulvovaginal cancers: Verrucous carcinoma, aggressive angiomyxoma, vulvar yolk sac tumor
Clinical case A 38-year-old woman presents to her general gynecologist with a complaint of a vaginal “cyst” at the introitus. She notes some fullness at the opening to the vagina and feels that this interferes with penetrative intercourse. She denies…
Vulvar extramammary Paget disease
Clinical case A 72-year-old patient presents with a 6-month history of vulvar pruritus and irritation. She has tried multiple antifungal medications with no improvement. On physical examination, she has an erythematous plaque-like rash involving the perineum and bilateral labia majora…
Bartholin gland carcinomas
Clinical case A 62-year-old woman presents to her general gynecologist with a complaint of right-sided vulvar itching and discomfort over the past 2 months. She is an otherwise healthy person who receives age-appropriate, routine health maintenance, and screening. She notes…
Vulvovaginal melanoma
Clinical case A 44-year-old nulliparous female presents with vaginal discharge. A vaginal tumor is biopsied, revealing invasive melanoma. On physical exam, there is a 5 cm polypoid and mostly hypopigmented lesion with a broad base arising from the right lateral…
Clear cell carcinoma of the vagina and cervix
Clinical case A 29-year-old G2P2 woman with a known bicornuate uterus presents to the office with irregular vaginal bleeding. A pelvic exam demonstrates a 2 cm friable lesion on the proximal vagina adjacent to the cervix ( Fig. 16.1 ).…
Other rare cervical cancers: cervical rhabdomyosarcoma, adenoid cystic carcinoma, verrucous carcinoma
Introduction The overwhelming majority of cervical cancer cases will be either squamous cell or adenocarcinoma. In a National Cancer Database (NCDB) study of cervical cancer in the United States, 79.5% of cervical cancer cases consisted of the squamous cell subtype,…
High grade neuroendocrine carcinoma of the cervix
Clinical case A 32-year-old G0 female presents with a newly diagnosed small cell neuroendocrine carcinoma (NEC) of the cervix. On physical exam, she is noted to have a 1.5 cm lesion on the anterior lip of the cervix with no…
Other rare uterine cancers: neuroendocrine tumors, yolk sac tumors, choriocarcinoma
Neuroendocrine tumors Epidemiology Incidence and mortality Neuroendocrine carcinomas (NEC) of the endometrium, which includes both small-cell and large-cell variants, are rare, highly aggressive tumors that account for approximately 0.8% of endometrial carcinomas. They generally present with advanced stage disease. The…