Tumors of the vagina can either be benign (non-cancerous) or malignant (cancerous). There are certain tumors that are classified as atypical (uncertain or unspecified behavior) meaning that some behave in a benign manner, or some behave in a malignant manner. A majority of the vaginal tumors diagnosed via lab studies (biopsy) are benign.

The World Health Organization (WHO) is an authoritative body that compiles, prepares, and publishes histological and molecular classification of tumors, via their Blue Books, based on research inputs from experts worldwide. These reference books chiefly aid in global cancer research, provide gold standards for tumor diagnosis, and help in treating cancer patients.

According to the WHO Classification of Female Genital Tumors (2020), 5th Ed., Vol. 4, benign and malignant tumors of the vagina are classified in the following manner:

Tumors of the vagina:

• Tumors of the vagina

Epithelial tumors

• Benign squamous lesions
  • Condyloma acuminatum: It is one of the most commonly transmitted sexual infections caused by the human papilloma virus (HPV). It manifests as a benign wart on the genitalia, and commonly occurs in sexually-active females
  • Squamous papilloma of the vagina: It is a rare and benign tumor of the vagina that is generally observed in young and middle-aged women
  • Atrophy of the vagina
  • Tubulosquamous polyp: It is an uncommon benign tumor of squamous epithelium that is mostly known to occur in women over 40
• Squamous cell tumors and precursors
  • Squamous intraepithelial lesions of the vagina
  • Squamous cell carcinoma, HPV-associated, of the vagina
  • Squamous cell carcinoma, HPV-independent, of the vagina
  • Squamous cell carcinoma NOS of the vagina: It is a rare malignancy affecting the skin and mucosal membranes of the vagina, generally in middle-aged and older women
• Benign glandular lesions
  • Villous adenoma: It is an extremely rare glandular lesion resembling a colorectal villous adenoma. It is generally observed in middle-aged women
  • Mullerian papilloma of the vagina: It is a rare benign tumor of the vagina. A vast majority of the tumors are found in young girls (children)
  • Vaginal adenosis: It is the presence of benign cervical/endometrial glandular tissues in the vaginal wall. It is a common condition that is mostly seen in healthy adult women
  • Endocervicosis of the vagina: It is a rare, benign condition in which an abnormal presence of endocervical glands (of uterine cervix) on the walls of the vagina is noted. The condition is generally seen in adult women
  • Cysts of the vagina: Vaginal Cysts are rare, benign, and usually fluid-filled lesions that form on the vaginal walls in adult women. A majority of these cysts are small and asymptomatic
• Glandular tumors
  • Adenocarcinoma, HPV-associated, of the vagina
  • Endometrioid carcinoma of the vagina: It is a rare histological variant of vaginal adenocarcinoma that affects women over 50
  • Clear cell carcinoma of the vagina
  • Mucinous carcinoma, gastric type, of the vagina
  • Mucinous carcinoma, intestinal type, of the vagina
  • Mesonephric adenocarcinoma of the vagina: It is a rare histological variant of vaginal adenocarcinoma that generally affects women over 50
  • Carcinosarcoma of the vagina: It is an extremely rare malignancy arising in the vagina. It is generally observed in women following menopause
• Other epithelial tumors
  • Mixed tumor of the vagina: It is a rare, benign tumor that occurs in the vagina. It is often noted in adult women
  • Adenocarcinoma of Skene gland origin: Skene Gland’s Adenocarcinoma is a rare and malignant tumor that typically affects middle-aged and elderly women
  • Adenosquamous carcinoma of the vagina: It is a rare form of carcinoma having malignant squamous cells and glandular cells. It can affect women of a wide age group
  • Adenoid basal carcinoma of the vagina: It is an extremely uncommon vaginal cancer that is mostly observed in postmenopausal women

Mixed epithelial and mesenchymal tumors

• Adenosarcoma of the vagina: It is an extremely rare low-grade cancer commonly affecting middle-aged women following menopause

Miscellaneous tumors

• Germ cell tumors of the vagina

Additional vaginal tumor articles (on DoveMed) that are not part of WHO Classification of Female Genital Tumors:

Aggressive Angiomyxoma of Vagina: It is a rare, benign, soft tissue tumor with subcutaneous and deep tissue involvement. mostly found in young and middle-aged women.

Angiomyofibroblastoma of Vagina: It is a benign tumor of the soft tissues that occurs in the vagina of young and middle-aged women.

Angiomyolipoma of Vagina: It is an extremely uncommon extrarenal angiomyolipoma that may be present in adult women. An angiomyolipoma is a benign tumor that is a mixture of blood vessels, smooth muscles, and fat.

Basaloid Squamous Cell Carcinoma of Vagina: It is a rare histological variant of vaginal squamous cell carcinoma. It usually affects women over 50.

Blue Nevus of Vagina: It is an extremely rare, benign lesion that is composed of spindle pigmented cells. A blue nevus is a benign condition that may be present at birth or form at any age in an individual.

Embryonal Rhabdomyosarcoma of Vagina: It is the most common histological subtype of vaginal rhabdomyosarcoma affecting very young girls (children).

Endometriosis of Vagina: It is tissue of the endometrium occurring in the walls of the vagina. The condition typically affects menstruating women.

Epidermolytic Acanthoma of Vaginal Mucosa: It is a benign tumor that occurs in the vagina. It can affect females of any age group.

Fibroepithelial Polyp of Vagina: It is a rare, benign tumor that arises from the skin of the vagina. The polyp is typically seen in adult women during pregnancy.

Gartner Duct Cysts of Vagina: These are benign vaginal cyst types that are generally seen between the ages 20 and 75 years in women.

Giant Angiomatoid Cellular Blue Nevus of Vagina: It is a rare variant of vaginal blue nevus. In some cases, the tumor is associated with pregnancy and may present as a slow-growing soft tissue mass.

Keratinizing Squamous Cell Carcinoma of Vagina: It is a rare histological variant of vaginal squamous cell carcinoma. It is usually seen in women over 50 years’ old.

Leiomyoma of Vagina: It is a benign smooth muscle tumor that is present in the vagina. The tumor may be found in young and middle-aged women.

Leiomyosarcoma of Vagina: It is the most common subtype of adult vaginal sarcoma found in middle-aged women. Leiomyosarcoma is a rare form of connective tissue cancer.

Mucoepidermoid Carcinoma of Vagina: It is an exceedingly rare variant of vaginal adenosquamous carcinoma. It can be seen in women of a wide age group.

Müllerian Cysts of Vagina: These are common vaginal cyst types. These benign cysts are mostly observed in adult women.

Non-Keratinizing Squamous Cell Carcinoma of Vagina: It is the most common histological variant of vaginal squamous cell carcinoma. It is usually seen in women over 50 years’ old.

Papillary Squamotransitional Carcinoma of Vagina: It is a rare histological variant of vaginal squamous cell carcinoma that generally occurs in women above 50.

Postoperative Spindle-Cell Nodule of Vagina: It is a rare, benign tumor that forms due to an injury (tissue damage); usually, from a surgical procedure involving the female genital tract. It is normally observed in young and middle-aged women.

Primary Diffuse Large B-Cell Lymphoma of Vagina: It is a rare, B-cell non-Hodgkin’s lymphoma that affects middle-aged and older women. It is the most common subtype of vaginal lymphoma.

Primary Intestinal Type Adenocarcinoma of Vagina: It is an exceedingly rare malignancy of intestinal type that arises in the vagina. The cancer may affect a wide age range of adult women.

Rhabdomyoma of Vagina: It is an infrequently occurring benign tumor of the connective tissues observed in adult women.

Rhabdomyosarcoma of Vagina: It is a very uncommon, high-grade malignancy of the vagina. It typically affects young girls (children).

Sebaceous Cyst of Vagina: It is a type of benign vaginal cyst that is observed in women of a wide age range.

Skene Gland Carcinoma of the Urethra: It is an exceedingly rare malignant tumor that arises in the female urethra. Postmenopausal women are at an increased risk for the same.

Skene’s Duct Cyst: When the duct of the Skene’s glands gets blocked, fluid gets accumulated causing the gland to swell and form a cyst. The condition is noted in adult women.

Solitary Fibrous Tumor of Vagina: It is a mostly benign overgrowth arising from the mesenchymal tissue. The tumor may be present in women between 20 and 70 years of age.

Squamous Epithelial Inclusion Cysts of Vagina: These are the most common vaginal cyst types that are generally observed in adult women.

Superficial Angiomyxoma of Vagina: It is a benign tumor located in the surface of the vagina, with subcutaneous tissue involvement. It is mostly found in young adult women.

Superficial Myofibroblastoma of Vagina: It can be described as an unusual, benign soft tissue tumor affecting the vagina. The tumor is generally observed in adult women.

Transitional Metaplasia of Vagina: It is an uncommon benign condition, wherein there is formation of transitional epithelium. The condition affects older women following menopause.

Tubovillous Adenoma of Vagina: It is an extremely infrequent, glandular lesion resembling a colorectal tubovillous adenoma. It is generally observed in middle-aged women.

Tubular Adenoma of Vagina: It is an extremely infrequent, glandular lesion resembling a colorectal tubular adenoma. It is generally observed in middle-aged women.

Undifferentiated Sarcoma of Vagina: It is an exceedingly rare and typically high-grade tumor of the mesenchymal tissues of vagina. Adult women of a wide age range may be affected by the tumor.

Urothelial Cysts of Vagina: These are very uncommon vaginal cyst types that are mostly observed in adult women.

Verrucous Carcinoma of Vagina: It is a rare histological variant of vaginal squamous cell carcinoma that usually affects women over 50.

Warty (Condylomatous) Carcinoma of Vagina: It is a rare histological variant of vaginal squamous cell carcinoma. It usually develops in postmenopausal women.