Primary invasive carcinoma of the vagina is rare, accounting for less than 3 percent of malignant tumors of the female genital tract. Vaginal intraepithelial neoplasia, a precursor of invasive vaginal carcinoma, is even less common.
1 Cytologic screening for vaginal tumors is not useful, unless there is a history of neoplasia of the lower genital tract.
2,3 We treated three women with high-grade vaginal intraepithelial neoplasia by applying 5 percent imiquimod cream vaginally. Imiquimod induces the secretion of interferon-α, interleukin-12, and tumor necrosis factor α from mononuclear cells.