grape sarcoma

Introduction

Introduction to grape sarcoma More than 90% of vaginal malignant tumors in children are grape sarcoma, which is a highly malignant tumor. Most of them progress rapidly and the prognosis is extremely poor. More common in infants and young children. The tumor is derived from the primitive mesenchymal cells in the superficial tissue of the vaginal wall. The predilection site is the upper part of the vaginal wall, especially in the previous wall. basic knowledge Sickness ratio: 0.05%-0.08% Susceptible people: more common in infants and young children Mode of infection: non-infectious complication:

Cause

Cause of grape sarcoma

(1) Causes of the disease

Domestic reports, primary vaginal cancer is early marriage, premature delivery, some patients have long-term use of pessary or have a history of pelvic radiotherapy.

Human papilloma virus (30%):

It may be partly related to HPV and vaginal mucosal developmental abnormalities, known as vaginal intraepithelial neoplasia (VAIN), HPV infection vaginal intraepithelial neoplasia invasive cancer, this process has been reported, but the exact possibility is not yet clear.

Estrogen (29%):

Young women with vaginal clear cell carcinoma are associated with taking estrogen during their mother's pregnancy. The risk is 1, especially in women who are exposed to the first 12 weeks of pregnancy.

(two) pathogenesis

Diffusion and transfer:

1. Direct dissemination to adjacent soft tissues and bone structures including the vagina, uterus, bladder, urethra, rectum and pelvis.

2. Lymph node dissemination The upper vaginal lymph node drainage is similar to cervical cancer, first reaching the pelvic cavity, then the para-aortic lymph node, the lower third of the vaginal drainage is similar to the vulvar cancer, to the groin and femoral lymph nodes, then to the pelvic lymph nodes, there is bidirectional drainage Maybe, especially the middle section.

3. Hematogenous dissemination occurs later, usually lung, liver, bone metastasis, lymph node metastasis, and blood transfer.

Prevention

Grape sarcoma prevention

The cause is still unclear, understanding the risk factors of tumors, and formulating corresponding prevention strategies can reduce the risk of tumors. There are two basic clues to prevent tumors. Even if tumors have begun to form in the body, they can help the body to improve resistance. The strategy is as follows:

1. Avoid harmful substances (promoting factors)

It is able to help us avoid or minimize exposure to harmful substances.

Some related factors of tumorigenesis are prevented before the onset, and many cancers can be prevented before they are formed. A report in the United States in 1988 compared the international malignant tumors in detail and proposed many external factors of known malignant tumors. In principle, it can be prevented, that is, about 80% of malignant tumors can be prevented by simple lifestyle changes, and traced back. In 1969, Dr. Higginson's research concluded that 90% of malignant tumors are caused by environmental factors," "Environmental factors", "lifestyle" refers to the air we breathe, the water we drink, the food we choose to make, the habits of activities, and social relationships.

2. Improve the body's immunity against tumors

Can help to strengthen and strengthen the body's immune system and cancer.

The focus of our current cancer prevention efforts should first focus on and improve those factors that are closely related to our lives, such as quitting smoking, eating properly, exercising regularly, and losing weight. Anyone who follows these simple and reasonable lifestyles can Reduce the chance of cancer.

The most important thing to improve the function of the immune system is: diet, exercise and control troubles. Healthy lifestyle choices can help us stay away from cancer. Maintaining good emotional state and proper physical exercise can keep the body's immune system at its best. Tumors and prevention of other diseases are equally beneficial. Other studies have shown that appropriate activities not only enhance the body's immune system, but also reduce the incidence of colon cancer by increasing the peristalsis of the human intestinal system. Here we mainly understand the diet in preventing tumorigenesis. Some questions.

Human epidemiology and animal studies have shown that vitamin A plays an important role in reducing the risk of cancer. Vitamin A supports normal mucosa and vision. It directly or indirectly participates in most of the body's tissue functions. Vitamin A is present in animal tissues. In the liver, whole eggs and whole milk, the plant is in the form of -carotene and carotenoids, which can be converted into vitamin A in the human body. Excessive intake of vitamin A can cause adverse reactions in the body and -carrot This is not the case with carotenoids, and the low vitamin A content in the blood increases the risk of malignant tumors. Studies have shown that those with low levels of vitamin A intake in the blood increase the likelihood of lung cancer, while those with low blood levels in smokers Levels of vitamin A ingestors have the potential to double lung cancer. Vitamin A and its mixture can help remove free radicals in the body (free radicals can cause damage to genetic material), and secondly stimulate the immune system and help differentiate cells in the body. Ordered tissue (while the tumor is characterized by disorder), some theories suggest that vitamin A can help early carcinogens Invasion mutated cells become reversed the occurrence of the normal growth of cells.

In addition, some studies suggest that supplementation with -carotene alone does not reduce the risk of cancer, but rather increases the incidence of lung cancer. However, when -carotene binds to vitamin C, E and other antitoxin substances, its protective effect. It is shown, because it can increase free radicals in the body when it is consumed by itself. In addition, there are interactions between different vitamins. Both human and mouse studies have shown that the use of -carotene can reduce 40% of vitamins in the body. At E-level, a safer strategy is to eat different foods to maintain a balanced vitamin to protect against cancer, as some protective factors have not been discovered so far.

Vitamin C, E is another anti-tumor substance that prevents the harm of carcinogens such as nitrosamines in food. Vitamin C protects sperm from genetic damage and reduces the risk of leukemia, kidney cancer and brain tumors in their offspring. Vitamin E can reduce the risk of skin cancer. Vitamin E has the same anti-tumor effect as vitamin C. It is a scavenger that protects against toxins and scavenges free radicals. The combination of vitamins A, C and E protects the body against toxins. Better than applying it alone.

At present, research on phytochemistry has attracted widespread attention. Phytochemistry is a chemical found in plants, including vitamins and other substances found in plants. Thousands of plant chemicals have been found, many of which have anticancer properties. The protective mechanism of these chemicals not only reduces the activity of carcinogens but also enhances the body's immunity against carcinogens. Most plants provide antioxidant activity that exceeds the protective effects of vitamins A, C, and E, such as a cup of cabbage. Contains 50mg of vitamin C and 13U of vitamin E, but its antioxidant activity is equivalent to the antioxidant activity of 800mg of vitamin C and 1100u of vitamin E. It can be inferred that the antioxidant effect in fruits and vegetables is far better than what we know. The effect of vitamins is strong, and no doubt natural plant products will help prevent cancer in the future.

Complication

Grape sarcoma complications Complication

Tumors are mainly local metastasis, and can be metastasized by blood and lymph. Tumors often involve the bladder, urethra, frequent urination, urinary retention and other symptoms. Tumors are rarely seen in the vagina.

Symptom

Symptoms of grape sarcoma Common symptoms Vaginal bleeding, abdominal tenderness, increased vaginal secretions, vaginal bloody secretions, vaginal discharge, and non-pregnant lower abdomen

There is no special performance when the disease starts. When the tumor grows to a certain volume, the child has vaginal bloody discharge or irregular vaginal bleeding, accompanied by a mass in the vagina, especially when the child is crying and adding abdominal pressure. That is, the tumor can be seen protruding from the vaginal opening.

Examine

Examination of grape sarcoma

Pap smear examination is controversial. Vaginal cancer is usually late at the time of screening and the screening rate is low. However, some authors believe that Pap smear examination is applied to the following situations:

1. Screening methods However, some authors believe that Pap smear examination is the basic method for screening the general population. Because 30% of vaginal cancer patients have a history of cervical cancer, these patients should undergo Pap smear every year.

2. Females have a history of exposure to diethylstilbestrol in the mother. Pelvic examination and Pap smear should be performed every year from menarche, because clear cell carcinoma can occur in childhood, so it should be carefully examined when there is vaginal bleeding or drainage.

3. Vaginal B-ultrasound should be performed.

Diagnosis

Diagnosis and differentiation of grape sarcoma

Diagnostic criteria

Typical grape sarcoma is not difficult to diagnose, but because of the early performance, most tumors have reached a considerable volume at the time of diagnosis. For infants with abnormal drainage or suspicious performance, vaginal examination should be performed as soon as possible, and the tumor should be detected immediately. Take biopsy for histological diagnosis, staging diagnosis: FIGO staging is as follows:

Stage 0: carcinoma in situ.

Stage I: The cancer is confined to the vaginal wall.

Stage II: The cancer has invaded the tissues around the vagina, but it has not reached the pelvic wall.

Stage III: The cancer has reached the pelvic wall.

Stage IV: The cancer has exceeded the true pelvis or the clinical involvement of the bladder and rectal mucosa.

Stage IVa: The tumor invades adjacent organs or directly expands the true pelvis.

Stage IVb: The tumor extends to distant organs.

Grape sarcoma and vaginitis identification, especially when the lesion is located at the distal end of the vagina is not easy to appear, resulting in missed diagnosis, misdiagnosis.

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