10 - Gynaecological tumours

Summary

Gynaecological tumours are rare in childhood and adolescence. Malignant tumours are fortunately particularly rare. Their rarity, however, may lead to problems, as the diagnosis may not be considered and individual clinicians may have insufficient experience to ensure appropriate treatment.

Childhood cancers differ from those found in adult life in their classification. Those found in the neonatal period are often embryonic tumours, while those in childhood are often sarcomas, as opposed to the carcinomas more frequently found in adult women. This chapter gives an overview of gynaecological tumours in childhood and adolescence only, as their management is extremely specialised and details are not appropriate at this level.

Tumours of the vulva

Tumours of the vulva are particularly rare in this age group. Tumours such as squamous cell carcinoma, malignant melanoma and sarcoma botryoides occur rarely and the only one that even specialists may see is haemangioma.

HAEMANGIOMA

Haemangiomas used to be classified as being either capillary or cavernous but this classification has now been abandoned. They are not usually present at birth but appear within a few weeks, undergoing a phase of rapid growth before undergoing spontaneous involution, although the time period for this is usually rather long.

Haemangiomas are composed, in the early stages, of proliferating masses of endothelial cells with occasional lumina, later, as they resolve, developing into large endothelial lined spaces. Haemangioma of the vulva, as elsewhere on the body, may be superficial or deep.