Recurrent carcinoma in situ of the vagina in patients previously treated for in situ carcinoma of the cervix.

Sixty-six patients were seen at the Mayo Clinic from 1950 through 1974 with in situ carcinoma of the vagina following various forms of treatment for a similar lesion of the cervix. Sixty-three patients have remained free of recurrent disease. One patient has been lost to followup, 1 patient required a second local excision, and 1 patient had recurrent carcinoma that progressed to invasive vaginal malignant disease. The recurrent malignant disease was usually asymptomatic; its presence was suggested by an abnormal Papanicolaou smear and confirmed by Schiller stain or colposcopically directed biopsy. Colposcopic examination of the vagina has greatly facilitated delineation of the lesion; this may allow relatively simple definitive therapy in some instances--that is, local excision or partial vaginectomy. Total vaginectomy, with or without skin graft vaginal reconstruction, must be carried out in patients who have multicentric lesions. The use of vaginal radium or external beam therapy should be limited to the elderly patients or those to whom a functional vagina is unimportant.