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Journal of the American Academy of... Dec 2019Vulvar malignancies represent a serious gynecologic health concern, especially given the increasing incidence over the past several decades. Squamous cell carcinoma and... (Review)
Review
Vulvar malignancies represent a serious gynecologic health concern, especially given the increasing incidence over the past several decades. Squamous cell carcinoma and melanoma are common subtypes, although other neoplasms, such as basal cell carcinoma and Paget disease of the vulva, might be seen. Many vulvar cancers are initially misdiagnosed as inflammatory conditions, delaying diagnosis and worsening prognosis. It is essential that dermatologists are familiar with characteristic findings for each malignancy to ensure appropriate diagnosis and management. Herein, we review the unique epidemiologic and clinical characteristics of each major vulvar malignancy, as well as discuss their respective prognoses and current management recommendations.
Topics: Carcinoma, Squamous Cell; Female; Humans; Melanoma; Paget Disease, Extramammary; Vulvar Neoplasms
PubMed: 31349045
DOI: 10.1016/j.jaad.2019.07.055 -
Wiener Medizinische Wochenschrift (1946) Apr 2015Vulvar malignancies are important tumors of the female reproductive system. They represent a serious health issue with an incidence between 2 and 7 per 100,000 and year.... (Review)
Review
Vulvar malignancies are important tumors of the female reproductive system. They represent a serious health issue with an incidence between 2 and 7 per 100,000 and year. We provide a review about most important cancer entities, i.e., melanoma, squamous cell carcinoma, basal cell carcinoma, neuroendocrine cancer, and skin adnexal malignancies.Squamous cell carcinoma is the most common vulvar malignancy that can develop from vulvar intraepithelial neoplasia or de novo. Basal cell carcinoma represents only 2% of all vulvar cancers. Melanoma of the vulva exists in two major types-superficial spreading and acral lentiginous. A special feature is the occurrence of multiple vulvar melanomas. Of the adnexal cancer types Paget's disease and carcinoma are seen more frequently than other adnexal malignancies. The dermatologist should be aware of this problem, since he might be the first to be consulted by patients for vulvar disease. Treatment should be interdisciplinary in close association to gynecologists, oncologists, and radiologists.
Topics: Carcinoma in Situ; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Diagnosis, Differential; Female; Humans; Melanoma; Neoplasm Staging; Neoplasms, Adnexal and Skin Appendage; Neuroendocrine Tumors; Paget Disease, Extramammary; Prognosis; Skin; Skin Neoplasms; Vulva; Vulvar Neoplasms
PubMed: 25930015
DOI: 10.1007/s10354-015-0354-9 -
Clinics in Dermatology 2018Vulvovaginal conditions are common in mature women. This reflects age-related changes in immunity and skin barrier function of vulvovaginal tissues. Vaginal atrophy is... (Review)
Review
Vulvovaginal conditions are common in mature women. This reflects age-related changes in immunity and skin barrier function of vulvovaginal tissues. Vaginal atrophy is commonly complicated by dryness and inflammation, which makes postmenopausal atrophic vaginitis a virtually ubiquitous condition. The differential of vaginitis includes inflammatory, infectious, and malignant diseases, plus drug hypersensitivity. Atrophic vaginitis is treated with estrogen replacement therapy. Vulvovaginal malignant melanoma occurs predominantly in postmenopausal women and carries a poor prognosis. Similarly, the incidence of vulvovaginal malignancies, such as squamous cell carcinoma and extramammary Paget disease, rises exponentially after 65 years of age. Early diagnosis of these malignancies is of utmost importance. Lichen sclerosus et atrophicus and vulvovaginal candidosis are among the most common postmenopausal vulvovaginal conditions. Lichen sclerosus et atrophicus is associated with significant morbidity, and its management can be challenging. The incidence of vulvovaginal candidosis increases in patients on estrogen replacement therapy.
Topics: Aging; Carcinoma, Squamous Cell; Female; Genital Diseases, Female; Humans; Melanoma; Paget Disease, Extramammary; Postmenopause; Skin Diseases; Vagina; Vaginal Neoplasms; Vaginitis; Vulva; Vulvar Neoplasms
PubMed: 29566925
DOI: 10.1016/j.clindermatol.2017.10.012 -
Acta Dermatovenerologica Croatica : ADC Mar 2019By definition, mucosal melanomas are malignant primary tumors originating from melanocytes located in the mucosal membranes of the nasal cavity and accessory sinuses,... (Review)
Review
By definition, mucosal melanomas are malignant primary tumors originating from melanocytes located in the mucosal membranes of the nasal cavity and accessory sinuses, oral cavity, lips and pharynx, and vulvar, vaginal or uterus, anorectal, or basically any other part of the mucosal surface lining. These malignant melanomas usually occur in occult sites, which in combination with the lack of early specific signs contributes to the delay in diagnosis and poor prognosis of the disease. Given the rarity of mucosal melanomas, knowledge about their pathogenesis and risk factors is insufficient and when compared with cutaneous and ocular melanoma, they have the lowest five-year survival rate. Surgical resection is frequently the first approach to primary tumors, even though the utility of lymph node surgery and radiation therapy is not well established. Novel molecular techniques such as whole exome sequencing have become routine in order to aid patient care. They show great promise in the treatment of rare and usually fatal diseases such as mucosal melanomas. Target therapy against c-KIT activating mutations, frequently seen in mucosal melanomas, and the immunotherapy have emerged as a promising treatment modality for these aggressive tumors.
Topics: Humans; Melanoma; Mucous Membrane
PubMed: 31032785
DOI: No ID Found -
Journal of the American Academy of... Aug 2014Mucosal melanomas are aggressive cancers of mucosal surfaces with clinical and pathologic characteristics distinct from cutaneous melanomas, warranting different staging... (Review)
Review
Mucosal melanomas are aggressive cancers of mucosal surfaces with clinical and pathologic characteristics distinct from cutaneous melanomas, warranting different staging systems and treatment approaches. Surgical resection is performed frequently for the primary tumor, although the utility of lymph node surgery and radiation therapy is not established. Therapies targeted against C-KIT activating mutations, identified in many mucosal melanomas, are emerging as promising treatments.
Topics: Gastrointestinal Neoplasms; Head and Neck Neoplasms; Humans; Melanoma; Mucous Membrane; Urogenital Neoplasms
PubMed: 24815565
DOI: 10.1016/j.jaad.2014.03.031 -
Biomedicines Jan 2022Mucosal melanomas (MM) are rare tumors, being less than 2% of all diagnosed melanomas, comprising a variegated group of malignancies arising from melanocytes in... (Review)
Review
Mucosal melanomas (MM) are rare tumors, being less than 2% of all diagnosed melanomas, comprising a variegated group of malignancies arising from melanocytes in virtually all mucosal epithelia, even if more frequently found in oral and sino-nasal cavities, ano-rectum and female genitalia (vulva and vagina). To date, there is no consensus about the optimal management strategy of MM. Furthermore, the clinical rationale of molecular tumor characterization regarding BRAF, KIT or NRAS, as well as the therapeutic value of immunotherapy, chemotherapy and targeted therapy, has not yet been deeply explored and clearly established in MM. In this overview, focused on anorectal and genital MM as models of rare melanomas deserving of a multidisciplinary approach, we highlight the need of referring these patients to centers with experts in melanoma, anorectal and uro-genital cancers treatments. Taking into account the rarity, the poor outcomes and the lack of effective treatment options for MM, tailored research needs to be promptly promoted.
PubMed: 35052829
DOI: 10.3390/biomedicines10010150 -
Anais Brasileiros de Dermatologia 2015Paget's disease, described by Sir James Paget in 1874, is classified as mammary and extramammary. The mammary type is rare and often associated with intraductal cancer... (Review)
Review
Paget's disease, described by Sir James Paget in 1874, is classified as mammary and extramammary. The mammary type is rare and often associated with intraductal cancer (93-100% of cases). It is more prevalent in postmenopausal women and it appears as an eczematoid, erythematous, moist or crusted lesion, with or without fine scaling, infiltration and inversion of the nipple. It must be distinguished from erosive adenomatosis of the nipple, cutaneous extension of breast carcinoma, psoriasis, atopic dermatitis, contact dermatitis, chronic eczema, lactiferous ducts ectasia, Bowen's disease, basal cell carcinoma, melanoma and intraductal papilloma. Diagnosis is histological and prognosis and treatment depend on the type of underlying breast cancer. Extramammary Paget's disease is considered an adenocarcinoma originating from the skin or skin appendages in areas with apocrine glands. The primary location is the vulvar area, followed by the perianal region, scrotum, penis and axillae. It starts as an erythematous plaque of indolent growth, with well-defined edges, fine scaling, excoriations, exulcerations and lichenification. In most cases it is not associated with cancer, although there are publications linking it to tumors of the vulva, vagina, cervix and corpus uteri, bladder, ovary, gallbladder, liver, breast, colon and rectum. Differential diagnoses are candidiasis, psoriasis and chronic lichen simplex. Histopathology confirms the diagnosis. Before treatment begins, associated malignancies should be investigated. Surgical excision and micrographic surgery are the best treatment options, although recurrences are frequent.
Topics: Breast Neoplasms; Carcinoma; Diagnosis, Differential; Female; Genital Neoplasms, Male; Humans; Male; Nipples; Paget Disease, Extramammary; Paget's Disease, Mammary; Skin Neoplasms; Vulvar Neoplasms
PubMed: 25830993
DOI: 10.1590/abd1806-4841.20153189 -
Life Sciences Mar 2017Histamine is a biogenic amine, synthetized and released by mast cells, which acts as a vasodilator in several pathologic processes, namely in allergies and... (Review)
Review
Histamine is a biogenic amine, synthetized and released by mast cells, which acts as a vasodilator in several pathologic processes, namely in allergies and conjunctivitis. Its role on cancer is not fully understood. High levels of histamine have been associated with a bivalent behavior in regulation of several tumors (i.e. cervical, ovarian, vaginal, uterine, vulvar, colorectal cancer, and melanoma), promoting or inhibiting their growth. Histamine receptors (H1, H2, H3 and H4) are present in a vast group of cells, including tumor cells, making them sensitive to histamine variations. In this work, we review the role of mast cells and histamine on cancer development and the possibility of use antihistamines in the clinical management of this disease.
Topics: Animals; Histamine Antagonists; Humans; Mast Cells; Neoplasms
PubMed: 27986539
DOI: 10.1016/j.lfs.2016.12.008 -
Dermatology Practical & Conceptual Apr 2018Vulvar melanoma is a rare and deadly cancer in women, and the prognosis is often poor. There are limited studies on the dermoscopic features of vulvar melanoma....
Vulvar melanoma is a rare and deadly cancer in women, and the prognosis is often poor. There are limited studies on the dermoscopic features of vulvar melanoma. Described criteria include the presence of blue, gray, or white colors. Herein we present the clinical and dermoscopic characteristics of a hypopigmented and heavily pigmented nodule in a 92-year-old and an 80-year-old woman. Dermoscopy in the former revealed structureless milky-red to white areas, remnants of brown pigmentation at the base and polymorphic vessels, while the latter displayed structureless blue-gray areas with black dots and peripheral lines at the base. In both cases, histopathology revealed a stage III melanoma. Our two cases along with a review of the literature suggest that the dermoscopic features described for diagnosing cutaneous nodular melanoma, apply also for vulvar melanoma. Clinicians should always raise the suspicion if observing plaques or nodules with a dermoscopic polymorphic vascular pattern and blue-black color on the genitals of postmenopausal women.
PubMed: 29785335
DOI: 10.5826/dpc.0802a16 -
Asian Journal of Urology Oct 2022Genitourinary (GU) melanoma is a rare presentation of melanoma accounting for approximately 0.5% of all melanomas. GU melanomas include primary melanomas of the vulva,... (Review)
Review
Genitourinary (GU) melanoma is a rare presentation of melanoma accounting for approximately 0.5% of all melanomas. GU melanomas include primary melanomas of the vulva, vagina, uterine cervix, ovary, penis, scrotum, urethra, bladder, ureter, and kidney. These melanomas are often diagnosed in advanced stages and stigma is thought to contribute to delays in presentation. As the likely diagnosing provider, it is imperative that dermatologists, urologists, and gynecologists are aware of these uncommon sites of presentation. While there have been major advances in the treatment of melanomas as a whole in the last 10 years, their applications to GU melanomas have often been overlooked. GU melanomas have not been included in many of the major phase III clinical trials which brought contemporary advanced treatments to market and the prognoses for GU melanomas remain poor. Due to the rarity of GU melanomas, much of the literature provides generalized recommendations across multiple different organs affected by GU melanomas or omits certain topics, making it difficult to appreciate the fundamentals of the individual presentations. This review aimed to provide background information on the pathogenesis and epidemiology of the different sites of GU melanomas and categorize data specific to the presentation, staging, treatment, and prognosis of each type of GU melanoma to guide the clinician. It was also meant to encourage a multidisciplinary approach to the management of these patients as it spans the expertise of surgical oncologists, medical oncologists, radiation oncologist, dermatologists, urologists, and gynecologists.
PubMed: 36381597
DOI: 10.1016/j.ajur.2022.01.003