Intraepithelial neoplasia of the neovagina.

Patients who require construction of a neovagina provide an opportunity for researchers to study some of the possible factors that cause vaginal neoplasia. Intraepithelial neoplastic changes occurring in the neovagina, remote from the graft margins, cannot be attributed to preexisting disease in the vaginal site. Such changes are unlikely to represent an expression of the oncogenic potential of the transplanted tissue. The most likely cause of these changes is the presence of a local carcinogenic environmental factor. Two cases are presented to demonstrate and support this thesis. The treatment prescribed, local excision in one case and application of topical 5-fluorouracil in the other case, resulted in disease-free intervals in excess of eight years for both patients.