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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Vulvar cancer differential diagnosis

Introduction

Overview

Overview

Vulvar cancer must be differentiated from other neoplastic vulvar lesions, non neoplastic vulvar lesions, and infectious disease lesions of vulva.

Differentiating vulvar cancer from other Diseases

Differentiating vulvar cancer from other Diseases

  • Vulvar cancer must be differentiated from other neoplastic vulvar lesions such as:
  • Vulvar cancer must be differentiated from other non neoplastic vulvar lesions such as:
  • Vulvar cancer must be differentiated from infectious disease lesions of vulva such as:

Other differential considerations include:

Diseases Clinical manifestations Para-clinical findings Gold standard
Symptoms Physical exam Lab Findings Imaging Histopathology
Abnormal

vaginal bleeding

Abnormal vaginal dyscharge Pelvic

pain

Itching or

burning of the vulva

Other Genitourinary/ Gastrointestinal symptoms B symptoms Abdominal pain Gynecological examinations Abdominal

mass

HPV Pap smear STI Panel Ultrasound MRI CT Scan
Vulvar cancer

+

+ +/- +/- + − − − Ultrasound: MRI:
  • Isointense on T1-weighted images
  • Soft-tissue mass with intermediate-to-high signal intensity on T2-weighted images
 Biopsy findings:
Vaginal cancer[1][2][3][4]

+

+ +/- +/- + − − − Ultrasound: MRI:
  • Isointense on T1-weighted images
  • Soft-tissue mass with intermediate-to-high signal intensity on T2-weighted images
 Biopsy findings:
Cervical cancer[5][6][7][8][9][10][11][12] + + + +

+

+ ± ±Chlamydia T2-weighted MRI :
  • Ovoid, heterogeneous tumor distending the cervical canal with stromal involvement.
 PET/CT scan:
Cervical polyp[13][14][15] + − − − − − − − − − May reveal presence of tumor CT contrast may show presence of a well defined mass
Cervical leiomyoma[16][17][18][19][20][21][22][23] + + − − + ±
    		− − −
    • Well circumscribed hyperechoic mass
    		 T2-weighted MRI:
    • Hypointense masses
    • Homogeneous

    enhancement

    • Red degeneration
    		 N/A
    Cervical lymphoma[24][25][26] − + − + +
    • Irregularity
    		 + − − −
    • Well-defined, solid, concentric, hypoechoic mass
    		 MRI: Diffuse heterogeneous uterine/cervical mass & hypoechoic enlarged iliac lymph nodes
    Cervical sarcoma[27][28][29][30] ± + − ± + + − − − MRI: N/A
    Cervical erosion(Ectropion)[31][32][33][34][35] + + ± − + − − − − – N/A N/A N/A
    Cervicitis[36][37][38][39] + + +/- − − − To detect complications like PID N/A N/A N/A
    IUD use[40][41][42] ± + − +/- − − − ± To detect IUD location and pregnancy N/A N/A N/A Physical exam and ultrasound
    Pelvic inflammatory diseases[43][44] + +
    • Fever
    		 ±Abdominal

    pain

    		− − − Thickened fluid filled fallopian tubes N/A May show endometritis
    Endometriosis[45][46][47][48][49][50] ± − − + + − − −
    • Unilocular/multilocular cysts contating thin/thick septations
    • Increased vascularity showing increased doppler flow
    • Hyperintensity on T1 weighted images
    • Hypointensity on T2 weighted images
    		 Presence of endometrial tissue outside the uterus
    Adenomyosis[51][52][53][54][55] − + − − +/- +/- − − − MRI:
    • Thickened junctional zone
    Cervical ectopic pregnancy[56][57] − − − − + − − T2-weighted MRI:
    • Hypointense large mass

    T1-weighted MRI:

    • Partially hyperintense mass
    		 N/A
    DES exposure (Clear cell adenocarcinoma)[58][59][60] + +/- +/- +/- + – − − − To determine uterine extent To detect metastases
    Paget’s disease of vulva to cervix[61][62][63] ± − − −
      		− − − − − N/A MRI:
      • Hyperintense on diffusion weighted images
      Nabothian cyst[64][65][66][67] + − − − – − − − −
      • Intermediate or slightly high signal intensity on T1-weighted
      • High signal intensity on T2-weighted images
      • Small cysts not visible on CT
      • Large cysts seen as focal low attenuation region
      Rectal cancer[68][69][70][71][72] – – + – Weight loss + LLQ + NL + – – +/- Endoscopic/transrectal US detects tumor extent Determine tumor stage Determine tumor stage Colonoscopy with biopsy
      Submucous uterine leiomyoma[73][74][75] Menorrhagia – + – – + Enlarged, irregular, firm, nontender uterus + – – – Provides information on no: of fibroids, size, vascularization, relationship with endometrial cavity & serosal surface Not required Not required Physical examination with Ultrasound
      Uterine cancer[76][77][78][79] + + – + + – – – Thickened endometrial lining >4cm Not required Histologic diagnosis
      Vaginal lymphoma[80][81][82] + + + + Abdominal/pelvic pain – + Palpable mass between rectum & vagina +/- – – – Diffuse mass in external cervical orifice & invading the vagina Diffuse mass in external cervical orifice & invading the vagina Not required CD20 & CD79a positive Immunohistochemistry & biopsy
      Vaginal polyp[83][84][85][86] Postmenopausal bleeding + + + – + Mass protruding from vagina +/- – – – To exclude uterine hyperplasia/carcinoma To determine the extent N/A Benign tissue/premalignant cells Excisional biopsy
      Vaginal adenosis[87][88] +/- +/- +/- – – – Palpable cysts,nodularity or ulcers – – – – N/A N/A N/A Columnar cells in the ectocervix Biopsy with histopathological examination
      References

      References

      1. ↑ Tarney CM, Han J (2014). “Postcoital bleeding: a review on etiology, diagnosis, and management”. Obstet Gynecol Int. 2014: 192087. doi:10.1155/2014/192087. PMC 4086375. PMID 25045355.
      2. ↑ Miccò, Maura; Sala, Evis; Lakhman, Yulia; Hricak, Hedvig; Vargas, Hebert Alberto (2015). “Imaging Features of Uncommon Gynecologic Cancers”. American Journal of Roentgenology. 205 (6): 1346–1359. doi:10.2214/AJR.14.12695. ISSN 0361-803X.
      3. ↑ Kim, Hwi-Gon; Song, Yong Jung; Na, Yong Jin; Choi, Ook-Hwan (2013). “A Case of Vaginal Cancer with Uterine Prolapse”. Journal of Menopausal Medicine. 19 (3): 139. doi:10.6118/jmm.2013.19.3.139. ISSN 2288-6478.
      4. ↑ Karateke A, Tugrul S, Yakut Y, Gürbüz A, Cam C (2006). “Management of a case of primary vaginal cancer with irreducible massive uterine prolapse–a case report”. Eur. J. Gynaecol. Oncol. 27 (5): 528–30. PMID 17139994.
      5. ↑ Hippisley-Cox J, Coupland C (January 2013). “Symptoms and risk factors to identify women with suspected cancer in primary care: derivation and validation of an algorithm”. Br J Gen Pract. 63 (606): e11–21. doi:10.3399/bjgp13X660733. PMC 3529288. PMID 23336450.
      6. ↑ Dunyo, Priscilla; Effah, Kofi; Udofia, Emilia Asuquo (2018). “Factors associated with late presentation of cervical cancer cases at a district hospital: a retrospective study”. BMC Public Health. 18 (1). doi:10.1186/s12889-018-6065-6. ISSN 1471-2458.
      7. ↑ Khalife D, El Housheimi A, Khalil A, Saba C S, Seoud M, Rammal R, Abdallah IE, Abdallah R (February 2019). “Treatment of cervical cancer metastatic to the abdominal wall with reconstruction using a composite myocutaneous flap: A case report”. Gynecol Oncol Rep. 27: 38–41. doi:10.1016/j.gore.2018.12.006. PMC 6302027. PMID 30603660. Vancouver style error: name (help)
      8. ↑ . doi:10.1097/PAS.0000000000000498. Check |doi= value (help). Missing or empty |title= (help)
      9. ↑ Brenner PF (September 1996). “Differential diagnosis of abnormal uterine bleeding”. Am. J. Obstet. Gynecol. 175 (3 Pt 2): 766–9. PMID 8828559.
      10. ↑ Alcázar, Juan Luis; Arribas, Sara; Mínguez, José Angel; Jurado, Matías (2014). “The Role of Ultrasound in the Assessment of Uterine Cervical Cancer”. The Journal of Obstetrics and Gynecology of India. 64 (5): 311–316. doi:10.1007/s13224-014-0622-4. ISSN 0971-9202.
      11. ↑ Qing L, Xiang T, Guofu Z, Weiwei F (September 2014). “Leukemoid reaction in cervical cancer: a case report and review of the literature”. BMC Cancer. 14: 670. doi:10.1186/1471-2407-14-670. PMC 4174654. PMID 25223869.
      12. ↑ Qing L, Xiang T, Guofu Z, Weiwei F (September 2014). “Leukemoid reaction in cervical cancer: a case report and review of the literature”. BMC Cancer. 14: 670. doi:10.1186/1471-2407-14-670. PMC 4174654. PMID 25223869.
      13. ↑ Mitchell H (May 2004). “Vaginal discharge–causes, diagnosis, and treatment”. BMJ. 328 (7451): 1306–8. doi:10.1136/bmj.328.7451.1306. PMC 420177. PMID 15166070.
      14. ↑ Irene Pecorella, Marco Monti, Maria Luisa Framarino Dei Malatesta & Gaia Ciardi (2018). “Polyp of the uterine cervix with heterologous fatty tissue”. Indian journal of pathology & microbiology. 61 (4): 593–595. doi:10.4103/IJPM.IJPM_105_17. PMID 30303160. Unknown parameter |month= ignored (help)
      15. ↑ Seema Anushka Tirlapur, Adewale Adeyemo, Neil O’Gorman & Dan Selo-Ojeme (2010). “Clinico-pathological study of cervical polyps”. Archives of gynecology and obstetrics. 282 (5): 535–538. doi:10.1007/s00404-010-1364-x. PMID 20091045. Unknown parameter |month= ignored (help)
      16. ↑ Al-Habib A, Elgamal EA, Aldhahri S, Alokaili R, AlShamrani R, Abobotain A, AlRaddadi K, Alkhalidi H (November 2016). “Large primary leiomyoma causing progressive cervical deformity”. J Surg Case Rep. 2016 (11). doi:10.1093/jscr/rjw190. PMC 5159177. PMID 27887011.
      17. ↑ Adaikkalam J (April 2016). “Lipoleiomyoma of Cervix”. J Clin Diagn Res. 10 (4): EJ01–2. doi:10.7860/JCDR/2016/16505.7531. PMID 27190823.
      18. ↑ Houser, L. Murray; Carrasco, C. H.; Sheehan, C. R. (1979). “Lipomatous tumour of the uterus: radiographic and ultrasonic appearance”. The British Journal of Radiology. 52 (624): 992–993. doi:10.1259/0007-1285-52-624-992. ISSN 0007-1285.
      19. ↑ Keriakos, Remon; Maher, Mark (2013). “Management of Cervical Fibroid during the Reproductive Period”. Case Reports in Obstetrics and Gynecology. 2013: 1–3. doi:10.1155/2013/984030. ISSN 2090-6684.
      20. ↑ Coronado GD, Marshall LM, Schwartz SM (May 2000). “Complications in pregnancy, labor, and delivery with uterine leiomyomas: a population-based study”. Obstet Gynecol. 95 (5): 764–9. PMID 10775744.
      21. ↑ Kamra, Hemlata T (2013). “Myxoid Leiomyoma of Cervix”. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. doi:10.7860/JCDR/2013/6171.3805. ISSN 2249-782X.
      22. ↑ El-agwany, Ahmed Samy (2015). “Lipoleiomyoma of the uterine cervix: An unusual variant of uterine leiomyoma”. The Egyptian Journal of Radiology and Nuclear Medicine. 46 (1): 211–213. doi:10.1016/j.ejrnm.2014.10.001. ISSN 0378-603X.
      23. ↑ Chaparala RP, Fawole AS, Ambrose NS, Chapman AH (March 2004). “Large bowel obstruction due to a benign uterine leiomyoma”. Gut. 53 (3): 386, 430. PMC 1773948. PMID 14960521.
      24. ↑ Grace A, O’Connell N, Byrne P, Prendiville W, O’Donnell R, Royston D, Walsh CB, Leader M, Kay E (1999). “Malignant lymphoma of the cervix. An unusual presentation and a rare disease”. Eur. J. Gynaecol. Oncol. 20 (1): 26–8. PMID 10422676.
      25. ↑ Kanaan, Daniel; Parente, Daniella Braz; Constantino, Carolina Pesce Lamas; Souza, Rodrigo Canellas de (2012). “Linfoma de colo de útero: achados na ressonância magnética”. Radiologia Brasileira. 45 (3): 167–169. doi:10.1590/S0100-39842012000300009. ISSN 0100-3984.
      26. ↑ Frey NV, Svoboda J, Andreadis C, Tsai DE, Schuster SJ, Elstrom R, Rubin SC, Nasta SD (September 2006). “Primary lymphomas of the cervix and uterus: the University of Pennsylvania’s experience and a review of the literature”. Leuk. Lymphoma. 47 (9): 1894–901. doi:10.1080/10428190600687653. PMID 17065003.
      27. ↑ Wright JD, Rosenblum K, Huettner PC, Mutch DG, Rader JS, Powell MA, Gibb RK (November 2005). “Cervical sarcomas: an analysis of incidence and outcome”. Gynecol. Oncol. 99 (2): 348–51. doi:10.1016/j.ygyno.2005.06.021. PMID 16051326.
      28. ↑ Khosla, Divya; Gupta, Ruchi; Srinivasan, Radhika; Patel, Firuza D.; Rajwanshi, Arvind (2012). “Sarcomas of Uterine Cervix”. International Journal of Gynecological Cancer. 22 (6): 1026–1030. doi:10.1097/IGC.0b013e31825a97f6. ISSN 1048-891X.
      29. ↑ Miccò M, Sala E, Lakhman Y, Hricak H, Vargas HA (December 2015). “Imaging Features of Uncommon Gynecologic Cancers”. AJR Am J Roentgenol. 205 (6): 1346–59. doi:10.2214/AJR.14.12695. PMC 5502476. PMID 26587944.
      30. ↑ . doi:10.1097/IGC.0b013e31825a97f6. Check |doi= value (help). Missing or empty |title= (help)
      31. ↑ Mitchell L, King M, Brillhart H, Goldstein A (September 2017). “Cervical Ectropion May Be a Cause of Desquamative Inflammatory Vaginitis”. Sex Med. 5 (3): e212–e214. doi:10.1016/j.esxm.2017.03.001. PMC 5562466. PMID 28460993.
      32. ↑ Mitchell H (May 2004). “Vaginal discharge–causes, diagnosis, and treatment”. BMJ. 328 (7451): 1306–8. doi:10.1136/bmj.328.7451.1306. PMC 420177. PMID 15166070.
      33. ↑ Sharma, Abhishek; Ojha, Ranapratap; Sengupta, Parama; Chattopadhyay, Sarbani; Mondal, Soumit (2013). “Cervical intramural pregnancy: Report of a rare case”. Nigerian Medical Journal. 54 (4): 271. doi:10.4103/0300-1652.119670. ISSN 0300-1652.
      34. ↑ . doi:10.12865/CHSJ.42.02.11. Missing or empty |title= (help)
      35. ↑ Casey PM, Long ME, Marnach ML (February 2011). “Abnormal cervical appearance: what to do, when to worry?”. Mayo Clin. Proc. 86 (2): 147–50, quiz 151. doi:10.4065/mcp.2010.0512. PMC 3031439. PMID 21270291.
      36. ↑ Mattson SK, Polk JP, Nyirjesy P (July 2016). “Chronic Cervicitis: Presenting Features and Response to Therapy”. J Low Genit Tract Dis. 20 (3): e30–3. doi:10.1097/LGT.0000000000000225. PMID 27243142.
      37. ↑ Rosenfeld WD, Clark J (June 1989). “Vulvovaginitis and cervicitis”. Pediatr. Clin. North Am. 36 (3): 489–511. PMID 2660084.
      38. ↑ Meyer T (August 2016). “Diagnostic Procedures to Detect Chlamydia trachomatis Infections”. Microorganisms. 4 (3). doi:10.3390/microorganisms4030025. PMID 27681919.
      39. ↑ Woods, Jennifer L.; Bailey, Sarabeth L.; Hensel, Devon J.; Scurlock, Amy M. (2011). “Cervicitis in Adolescents: Do Clinicians Understand Diagnosis and Treatment?”. Journal of Pediatric and Adolescent Gynecology. 24 (6): 359–364. doi:10.1016/j.jpag.2011.06.006. ISSN 1083-3188.
      40. ↑ Trobough GE (March 1978). “Pelvic pain and the IUD”. J Reprod Med. 20 (3): 167–74. PMID 347074.
      41. ↑ D. Reinprayoon, S. Taneepanichskul, S. Niruthisard & S. Suwajanakon (1999). “Uterine histopathologic changes after Cu-Fix intrauterine device insertion”. Contraception. 59 (1): 63–65. PMID 10342087. Unknown parameter |month= ignored (help)
      42. ↑ Seyma Fadiloglu, B. Dilbaz, E. Fadiloglu & S. Dilbaz (2018). “Relationship between copper IUD complications and ultrasonographic findings”. Archives of gynecology and obstetrics. 297 (4): 989–996. doi:10.1007/s00404-018-4711-y. PMID 29428979. Unknown parameter |month= ignored (help)
      43. ↑ Hoenderboom BM, van Benthem B, van Bergen J, Dukers-Muijrers N, Götz HM, Hoebe C, Hogewoning AA, Land JA, van der Sande M, Morré SA, van den Broek I (January 2019). “Relation between Chlamydia trachomatis infection and pelvic inflammatory disease, ectopic pregnancy and tubal factor infertility in a Dutch cohort of women previously tested for chlamydia in a chlamydia screening trial”. Sex Transm Infect. doi:10.1136/sextrans-2018-053778. PMID 30606817. Vancouver style error: initials (help)
      44. ↑ Jaiyeoba O, Soper DE (2011). “A practical approach to the diagnosis of pelvic inflammatory disease”. Infect Dis Obstet Gynecol. 2011: 753037. doi:10.1155/2011/753037. PMC 3148590. PMID 21822367.
      45. ↑ Hsu AL, Khachikyan I, Stratton P (June 2010). “Invasive and noninvasive methods for the diagnosis of endometriosis”. Clin Obstet Gynecol. 53 (2): 413–9. doi:10.1097/GRF.0b013e3181db7ce8. PMC 2880548. PMID 20436318.
      46. ↑ Chamié, Luciana Pardini; Blasbalg, Roberto; Pereira, Ricardo Mendes Alves; Warmbrand, Gisele; Serafini, Paulo Cesar (2011). “Findings of Pelvic Endometriosis at Transvaginal US, MR Imaging, and Laparoscopy”. RadioGraphics. 31 (4): E77–E100. doi:10.1148/rg.314105193. ISSN 0271-5333.
      47. ↑ Datta S, Kunde K (July 2008). “From vaginal discharge to endometriosis: an unusual case of endometriosis in pregnancy”. J Obstet Gynaecol. 28 (5): 552–3. doi:10.1080/01443610802247352. PMID 18850447.
      48. ↑ Chamié, Luciana Pardini; Blasbalg, Roberto; Pereira, Ricardo Mendes Alves; Warmbrand, Gisele; Serafini, Paulo Cesar (2011). “Findings of Pelvic Endometriosis at Transvaginal US, MR Imaging, and Laparoscopy”. RadioGraphics. 31 (4): E77–E100. doi:10.1148/rg.314105193. ISSN 0271-5333.
      49. ↑ Bedaiwy MA, Falcone T (February 2004). “Laboratory testing for endometriosis”. Clin. Chim. Acta. 340 (1–2): 41–56. PMID 14734195.
      50. ↑ Van Holsbeke C, Van Calster B, Guerriero S, Savelli L, Paladini D, Lissoni AA, Czekierdowski A, Fischerova D, Zhang J, Mestdagh G, Testa AC, Bourne T, Valentin L, Timmerman D (June 2010). “Endometriomas: their ultrasound characteristics”. Ultrasound Obstet Gynecol. 35 (6): 730–40. doi:10.1002/uog.7668. PMID 20503240.
      51. ↑ Filip G, Balzano A, Cagnacci A (November 2018). “Histological evaluation of the prevalence of adenomyosis, myomas and of their concomitance”. Minerva Ginecol. doi:10.23736/S0026-4784.18.04291-0. PMID 30486633.
      52. ↑ Fujino T, Watanabe T, Shinmura R, Hahn L, Nagata Y, Hasui K (December 1992). “Acute abdomen due to adenomyosis of the uterus: a case report”. Asia Oceania J Obstet Gynaecol. 18 (4): 333–7. PMID 1492806.
      53. ↑ Fujino T, Watanabe T, Shinmura R, Hahn L, Nagata Y, Hasui K (December 1992). “Acute abdomen due to adenomyosis of the uterus: a case report”. Asia Oceania J Obstet Gynaecol. 18 (4): 333–7. PMID 1492806.
      54. ↑ Zhou Y, Wu B, Li H (October 1996). “[The value of serum CA125 assays in the diagnosis of uterine adenomyosis]”. Zhonghua Fu Chan Ke Za Zhi (in Chinese). 31 (10): 590–3. PMID 9275451.
      55. ↑ Courtney A. Woodfield, Evan S. Siegelman, Beverly G. Coleman & Drew A. Torigian (2009). “CT features of adenomyosis”. European journal of radiology. 72 (3): 464–469. doi:10.1016/j.ejrad.2008.08.002. PMID 18804933. Unknown parameter |month= ignored (help)
      56. ↑ Mouhajer M, Obed S, Okpala AM (June 2017). “Cervical Ectopic Pregnancy in Resource Deprived Areas: A Rare and Difficult Diagnosis”. Ghana Med J. 51 (2): 94–97. PMC 5611908. PMID 28955106.
      57. ↑ Rathod, Setu; Samal, SunilKumar (2015). “Cervical ectopic pregnancy”. Journal of Natural Science, Biology and Medicine. 6 (1): 257. doi:10.4103/0976-9668.149221. ISSN 0976-9668.
      58. ↑ Tantitamit T, Hamontri S, Rangsiratanakul L (May 2017). “Clear cell adenocarcinoma of the cervix in second generation young women who are without maternal exposure to diethylstilbestrol: A case report”. Gynecol Oncol Rep. 20: 34–36. doi:10.1016/j.gore.2017.02.008. PMC 5328756. PMID 28275694.
      59. ↑ Subrata Pal, Sritanu Jana & Kingshuk Bose (2015). “Clear cell carcinoma of cervix in a postmenopausal woman: A case report”. Journal of mid-life health. 6 (2): 85–87. doi:10.4103/0976-7800.158964. PMID 26167060. Unknown parameter |month= ignored (help)
      60. ↑ Mary G. Dandulakis, Aidas J. Mattis, Andrea R. Hagemann & Ian S. Hagemann (2018). “Cervical clear cell adenocarcinoma with an exceptionally low proliferation index: Report of a case”. Gynecologic oncology reports. 23: 16–19. doi:10.1016/j.gore.2017.12.006. PMID 29326971. Unknown parameter |month= ignored (help)
      61. ↑ van der Linden, M.; Meeuwis, K.A.P.; Bulten, J.; Bosse, T.; van Poelgeest, M.I.E.; de Hullu, J.A. (2016). “Paget disease of the vulva”. Critical Reviews in Oncology/Hematology. 101: 60–74. doi:10.1016/j.critrevonc.2016.03.008. ISSN 1040-8428.
      62. ↑ Lloyd J, Evans DJ, Flanagan AM (July 1999). “Extension of extramammary Paget disease of the vulva to the cervix”. J. Clin. Pathol. 52 (7): 538–40. PMC 501500. PMID 10605411.
      63. ↑ Shaco-Levy R, Bean SM, Vollmer RT, Papalas JA, Bentley RC, Selim MA, Robboy SJ (January 2010). “Paget disease of the vulva: a histologic study of 56 cases correlating pathologic features and disease course”. Int. J. Gynecol. Pathol. 29 (1): 69–78. doi:10.1097/PGP.0b013e3181b1cc5e. PMID 19952933.
      64. ↑ Casey PM, Long ME, Marnach ML (February 2011). “Abnormal cervical appearance: what to do, when to worry?”. Mayo Clin. Proc. 86 (2): 147–50, quiz 151. doi:10.4065/mcp.2010.0512. PMC 3031439. PMID 21270291.
      65. ↑ Bin Park, Sung; Lee, Jong Hwa; Lee, Young Ho; Song, Mi Jin; Choi, Hye Jeong (2010). “Multilocular Cystic Lesions in the Uterine Cervix: Broad Spectrum of Imaging Features and Pathologic Correlation”. American Journal of Roentgenology. 195 (2): 517–523. doi:10.2214/AJR.09.3619. ISSN 0361-803X.
      66. ↑ Torky, Haitham A. (2016). “Huge Nabothian cyst causing Hematometra (case report)”. European Journal of Obstetrics & Gynecology and Reproductive Biology. 207: 238–240. doi:10.1016/j.ejogrb.2016.10.042. ISSN 0301-2115.
      67. ↑ Okamoto, Yoshikazu; Tanaka, Yumiko O.; Nishida, Masato; Tsunoda, Hajime; Yoshikawa, Hiroyuki; Itai, Yuji (2003). “MR Imaging of the Uterine Cervix: Imaging-Pathologic Correlation”. RadioGraphics. 23 (2): 425–445. doi:10.1148/rg.232025065. ISSN 0271-5333.
      68. ↑ Chiara Molinari, Federica Matteucci, Paola Caroli & Alessandro Passardi (2015). “Biomarkers and Molecular Imaging as Predictors of Response to Neoadjuvant Chemoradiotherapy in Patients With Locally Advanced Rectal Cancer”. Clinical colorectal cancer. 14 (4): 227–238. doi:10.1016/j.clcc.2015.05.014. PMID 26170142. Unknown parameter |month= ignored (help)
      69. ↑ William Hamilton & Deborah Sharp (2004). “Diagnosis of colorectal cancer in primary care: the evidence base for guidelines”. Family practice. 21 (1): 99–106. PMID 14760054. Unknown parameter |month= ignored (help)
      70. ↑ Wolfgang B. Gaertner, Mary R. Kwaan, Robert D. Madoff & Genevieve B. Melton (2015). “Rectal cancer: An evidence-based update for primary care providers”. World journal of gastroenterology. 21 (25): 7659–7671. doi:10.3748/wjg.v21.i25.7659. PMID 26167068. Unknown parameter |month= ignored (help)
      71. ↑ V. Raman Muthusamy & Kenneth J. Chang (2007). “Optimal methods for staging rectal cancer”. Clinical cancer research : an official journal of the American Association for Cancer Research. 13 (22 Pt 2): 6877s–6884s. doi:10.1158/1078-0432.CCR-07-1137. PMID 18006793. Unknown parameter |month= ignored (help)
      72. ↑ Mohammad Sadegh Fazeli & Mohammad Reza Keramati (2015). “Rectal cancer: a review”. Medical journal of the Islamic Republic of Iran. 29: 171. PMID 26034724.
      73. ↑ Jacques Donnez & Marie-Madeleine Dolmans (2016). “Uterine fibroid management: from the present to the future”. Human reproduction update. 22 (6): 665–686. doi:10.1093/humupd/dmw023. PMID 27466209. Unknown parameter |month= ignored (help)
      74. ↑ Mohamed Sabry & Ayman Al-Hendy (2012). “Medical treatment of uterine leiomyoma”. Reproductive sciences (Thousand Oaks, Calif.). 19 (4): 339–353. doi:10.1177/1933719111432867. PMID 22378865. Unknown parameter |month= ignored (help)
      75. ↑ Sahana Gupta, Jude Jose & Isaac Manyonda (2008). “Clinical presentation of fibroids”. Best practice & research. Clinical obstetrics & gynaecology. 22 (4): 615–626. doi:10.1016/j.bpobgyn.2008.01.008. PMID 18372219. Unknown parameter |month= ignored (help)
      76. ↑ “ACOG practice bulletin, clinical management guidelines for obstetrician-gynecologists, number 65, August 2005: management of endometrial cancer”. Obstet Gynecol. 106 (2): 413–25. August 2005. PMID 16055605.
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      86. ↑ Alexis Heller, Adanna Ukazu & Qing Wang (2017). “Pseudosarcomatous Vaginal Polyp”. International journal of surgical pathology. 25 (1): 54–55. doi:10.1177/1066896916666676. Unknown parameter |month= ignored (help)
      87. ↑ Marguerite B. Vigliani (2017). “A Report of Two Cases of Age-Related Changes in Cervical Morphology in Postmenopausal Women with Vaginal Adenosis”. Case reports in obstetrics and gynecology. 2017: 9523853. doi:10.1155/2017/9523853. PMID 28316850.
      88. ↑ Tiantian Han, Ying Jin, Yan Li, Yalan Bi & Lingya Pan (2018). “Clinicopathologic features and outcomes of primary vaginal adenosis as a dermatologic and gynecologic burden: A retrospective study”. Medicine. 97 (49): e13470. doi:10.1097/MD.0000000000013470. PMID 30544435. Unknown parameter |month= ignored (help)

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