Vaginal Tumors in the Pediatric Age Group: The Children's Cancer Hospital Egypt (CCHE)-57357 Experience

Background: Primary vaginal malignancies are rare in children. Their management has evolved during the last decades from radical surgery to neoadjuvant chemotherapy followed by local control with conservative surgery or radiotherapy. Aim: To describe the presentation, management, and outcome of pediatric vaginal malignancies. Methods: Retrospective review of the medical records of children with 1ry vaginal malignancies who had been treated at the Children’s Cancer Hospital Egypt (CCHE)-57357 from June 2007 till December 2018. Results: During the 11 years, 34 pediatric patients with 1ry vaginal malignancies were identified. The histopathology was rhabdomyosarcoma (RMS) in 19 (55.9%) patients, germ cell tumor (GCT) in 13 (38.2%), and clear cell adenocarcinoma (CCA) in two (5.9%). Vaginal bleeding was the presenting symptom in 65% of the patients. The 5-year overall survival and event-free survival rates were 73.7% and 77.8%, respectively, in RMS patients. In GCT patients, the 5-year overall survival and event-free survival rates were 84.6% and 61.5%, respectively. One of the two CCA patients died because of disease progression and the other was alive with progressive disease. Conclusions: Primary vaginal tumors are rare in children and generally have a good prognosis. Treatment with chemotherapy only or with either conservative surgery or radiotherapy may achieve an excellent outcome in pediatric primary vaginal RMS and GCT.