title: Vaginal tumors in childhood: the experience of St. Jude Children's Research Hospital.
abstract: OBJECTIVE
  The aim of this study was to retrospectively analyze the clinical presentation, histology, treatment, and outcomes of children with vaginal tumors who were treated at a single institution.
  
  
  METHODS
  A retrospective review of medical records and pathologic materials of all children with vaginal tumors treated at St Jude Children's Research Hospital between 1970 and 2009 was conducted.
  
  
  RESULTS
  Eighteen patients (median age, 3.7 years; range, 0.1-15 years) were identified. Three different histologies were found: rhabdomyosarcoma (RMS; n = 13), germ cell tumor (n = 3), and clear cell adenocarcinoma (n = 2). Bleeding or blood-tinged discharge was the most common clinical presentation (66%), followed by a protruding mass (39%). Vaginal and uterine salvage was 44.4% (8 of 18 patients). Thirteen patients (72.2%) remain disease-free, with a median follow-up of 23.2 years (range, 2-39 years). Four patients (22.2%) died of disease progression (1 RMS, 2 germ cell tumor, and 1 clear cell adenocarcinoma), and 1 patient with RMS died of colon cancer 12 years after the primary diagnosis had been made.
  
  
  CONCLUSIONS
  Vaginal tumors are extremely rare in the pediatric population. Early recognition of symptoms like bleeding and a protruding vaginal mass may prevent morbidity and mortality. Our findings confirm the good prognosis of vaginal RMS.
authors.affiliation: Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN 38105-3678, USA.
authors.forename: Israel
authors.initials: I
authors.lastname: Fernandez-Pineda
authors.forename: Sheri L
authors.initials: SL
authors.lastname: Spunt
authors.forename: Lalit
authors.initials: L
authors.lastname: Parida
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Krasin
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Davidoff
authors.forename: Bhaskar N
authors.initials: BN
authors.lastname: Rao
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001918:Brachytherapy; D002648:Child; D002675:Child, Preschool; D003110:Colonic Neoplasms / Q000453:epidemiology; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D042241:Early Diagnosis; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007044:Hysterectomy; D007223:Infant; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000453:epidemiology; D059351:Organ Sparing Treatments; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D013714:Tennessee / Q000453:epidemiology; D016896:Treatment Outcome; D014625:Vaginal Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery
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