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Ugeskrift For Laeger May 2018Vulvar intraepithelial neoplasia (VIN) is a rare but premalig-nant condition. VIN has two aetiological pathways: a human papillomavirus (HPV)-dependent pathway, which is... (Review)
Review
Vulvar intraepithelial neoplasia (VIN) is a rare but premalig-nant condition. VIN has two aetiological pathways: a human papillomavirus (HPV)-dependent pathway, which is a vulvar high-grade squamous intraepithelial lesion (HSIL), and an HPV-independent pathway, called differentiated VIN (d-VIN), associated with lichen sclerosus. d-VIN is more aggressive than vulvar HSIL. In case of symptoms, a biopsy should be performed. The recurrence risk is high: 25-50% regardless of treatment type. We recommend treatment with imiquimod as first choice to avoid mutilating surgery. Particular attention must be payed to immunosuppressed patients with VIN. HPV-vaccine can be discussed with patients with vulvar HSIL.
Topics: Antineoplastic Agents; Carcinoma in Situ; Female; Humans; Imiquimod; Immunocompromised Host; Papillomaviridae; Papillomavirus Infections; Papillomavirus Vaccines; Precancerous Conditions; Vulvar Neoplasms
PubMed: 29761782
DOI: No ID Found -
Oncology (Williston Park, N.Y.) Jul 1996Melanomas of the vulva and vagina comprise < 2% of melanomas in women. Although their biologic behavior appears to be similar to that of cutaneous melanoma, vulvar and... (Review)
Review
Melanomas of the vulva and vagina comprise < 2% of melanomas in women. Although their biologic behavior appears to be similar to that of cutaneous melanoma, vulvar and vaginal melanomas appear to have a different etiology. Women presenting with pigmented vulvar lesions should undergo expedited examination and full-thickness biopsy. Vulvar and vaginal melanomas should be staged surgically using the AJCC system, which incorporates Breslow and Clark microstaging. Adverse prognostic factors include advanced age at diagnosis, central location of tumor, capillary lymphatic space involvement, ulceration, high mitotic rate, and aneuploidy. Primary surgery should include radical local excision with 1-cm skin margins for melanomas < 1 mm thick and 2-cm margins for melanomas 1 to 4 mm thick. Deep margins should be at least 1 to 2 cm. Femoral inguinal lymphadenectomy should be performed in patients at increased risk of lymph node metastases on the basis of primary tumor characteristics. Adjuvant interferon-alfa appears to confer survival benefits in patients with regional nodal disease. Effective salvage therapy has not yet been identified.
Topics: Age Factors; Aged; Aneuploidy; Biopsy; Female; Humans; Interferon-alpha; Lymph Node Excision; Lymphatic Metastasis; Lymphatic System; Melanoma; Mitosis; Neoplasm Staging; Prognosis; Salvage Therapy; Survival Rate; Ulcer; Vaginal Neoplasms; Vulvar Neoplasms
PubMed: 8837119
DOI: No ID Found -
Critical Reviews in Oncology/hematology May 2016In this review, we provide an overview of the clinical aspects, histopathology, molecular genetics, and treatment options for Vulvar Paget's Disease (VPD), a rare skin... (Review)
Review
In this review, we provide an overview of the clinical aspects, histopathology, molecular genetics, and treatment options for Vulvar Paget's Disease (VPD), a rare skin disease, most commonly found in postmenopausal Caucasian women. The underlying cause of VPD remains not well understood. VPD is rarely associated with an underlying urogenital, gastrointestinal or vulvar carcinoma. In approximately 25% of the cases, VPD is invasive; in these cases, the prognosis is worse than in non-invasive cases. Recurrence rates in invasive VPD are high: 33% in cases with clear margins, and even higher when surgical margins are not clear, regardless of invasion. Historically, surgical excision has been the treatment of choice. Recent studies show that imiquimod cream may be an effective and safe alternative.
Topics: Diagnosis, Differential; Female; Humans; Paget Disease, Extramammary; Prognosis; Tumor Microenvironment; Vulvar Neoplasms
PubMed: 26971063
DOI: 10.1016/j.critrevonc.2016.03.008 -
The Pan African Medical Journal 2018We here report the case of a 58-year old female patient with no particular past medical history, presenting with a 5-year history of vulvar pruritis, drought and...
We here report the case of a 58-year old female patient with no particular past medical history, presenting with a 5-year history of vulvar pruritis, drought and vulvodynia at the Department of Dermatology. Clinical examination showed diffuse porcelaine lesions at the level of the vulva, with a yellowish hemispheric nodular lesion measuring 1 cm in diameter on the whitish plates and some excoriated lesions due to scratching. A skin biopsy was performed at the level of the whitish lesions and at the level of the nodular lesion. Histological examination suggested epidermoid carcinoma for the budding lesion and atrophic vulvar lichen sclerosus for the porcelaine lesions. Surgical treatment was recommended associated with radiation therapy. This study aims to highlight the risk for atrophic vulvar lichen sclerosu degeneration.
Topics: Biopsy; Carcinoma, Squamous Cell; Female; Humans; Middle Aged; Vulvar Lichen Sclerosus; Vulvar Neoplasms
PubMed: 29632624
DOI: 10.11604/pamj.2018.29.2.14414 -
The Pan African Medical Journal 2016
Topics: Choriocarcinoma; Female; Humans; Pregnancy; Uterine Neoplasms; Vulvar Neoplasms; Young Adult
PubMed: 28154683
DOI: 10.11604/pamj.2016.24.328.10482 -
Danish Medical Journal Mar 2017Malignant melanoma is a rare type of cancer in the vagina and vulva associated with a poor prognosis due to late diagnosis and early dissemination. Only a limited amount...
INTRODUCTION
Malignant melanoma is a rare type of cancer in the vagina and vulva associated with a poor prognosis due to late diagnosis and early dissemination. Only a limited amount of literature exists on the condition. This study elucidates the effect of current treatment.
METHODS
All patients diagnosed with malignant melanoma in the vagina or vulva at Aarhus University Hospital, Skejby, Denmark, in the period from 1996 to 2013 were included. Data were collected from the electronic patient records and from the Danish Pathology Register.
RESULTS
A total of 17 patients were included. The average age at the time of diagnosis was 77 years and the median overall survival time was 21.9 months. The five-year survival in this study was 17.7%. The majority of the melanomas were nodular and all of the superficially spreading melanomas were found in the vulva only. Malignant melanoma in the vagina has a poorer prognosis than in the vulva as it is diagnosed later.
CONCLUSIONS
Early diagnosis and staging of this cancer is important. Positron emission tomography-computed tom-ography should be the standard method for staging the disease. Older women with vaginal discharge should always have a gynaecological examination. The primary treatment is resection of the tumour, but future treatment might be a combination of resection and immunotherapy.
FUNDING
none.
TRIAL REGISTRATION
not relevant. .
Topics: Aged; Aged, 80 and over; Denmark; Female; Humans; Melanoma; Middle Aged; Registries; Retrospective Studies; Vaginal Neoplasms; Vulvar Neoplasms
PubMed: 28260594
DOI: No ID Found -
The Pan African Medical Journal 2017
Topics: Adenoma, Sweat Gland; Adult; Female; Humans; Sweat Gland Neoplasms; Vulvar Neoplasms
PubMed: 28674589
DOI: 10.11604/pamj.2017.26.196.11196 -
International Journal of Molecular... Jun 2021Vulvar squamous cell carcinoma (VSCC) is a rare malignancy with dual pathogenesis, Human papillomavirus (HPV)-associated and HPV-independent, with a poorly explored... (Review)
Review
Vulvar squamous cell carcinoma (VSCC) is a rare malignancy with dual pathogenesis, Human papillomavirus (HPV)-associated and HPV-independent, with a poorly explored molecular landscape. We aimed to summarize the findings of the series analyzing molecular hallmarks of this neoplasm. In January 2021, we conducted a comprehensive literature search using Pubmed Medline and Scopus to identify publications focused on genomic profiling of VSCC. Observational studies, including both prospective and retrospective designs, evaluating molecular alterations in VSCC were deemed eligible. A total of 14 studies analyzing 749 VSCC were identified. The study series were heterogeneous in HPV testing and sequencing strategies, included small sets of tumors and cancer genes, and commonly lacked survival analysis. Only one extensive targeted next-generation sequencing-based study comprised a large cohort of 280 VSCC. The mutated genes, their number, and frequencies were highly variable between the series. Overall, and followed by and were the most frequently studied and mutated genes. Mutations involved in the PI3K/AKT/mTOR pathway, including and have been consistently reported across the studies. However, the role of individual mutations or pathways in the development of VSCC remains unclear. In conclusion, heterogeneity and the small sample size of available molecular series contribute to a limited view of the molecular landscape of VSCC. Large-scale genome- or exome-wide studies with robust HPV testing are necessary to improve the molecular characterization of VSCC.
Topics: Carcinoma, Squamous Cell; Female; Humans; Mutation; Neoplasm Proteins; Vulvar Neoplasms
PubMed: 34209172
DOI: 10.3390/ijms22137069 -
Acta Clinica Croatica Mar 2021The aim of this retrospective study was to show the effect of clinical, pathologic, cytologic and therapeutic prognostic factors on treatment outcome and survival of...
The aim of this retrospective study was to show the effect of clinical, pathologic, cytologic and therapeutic prognostic factors on treatment outcome and survival of patients suffering from vulvar cancer and to determine prognostic significance of each of the individual factors, their mutual significance and impact on survival. The study included patients treated for vulvar cancer at Department of Gynecology and Obstetrics, Osijek University Hospital Centre during the 2000-2011 period. Retrospective analysis included data from patient medical files, along with their pathologic and cytologic findings, and oncologist findings. The study included 59 patients aged 45 to 88 years. Diagnosis was based on pathologic and cytologic status and staging. Univariate analysis showed the lymph node status, adjuvant radiotherapy, chemotherapy and clinical staging of the disease to be statistically significant prognostic factors for overall survival and prognosis of vulvar cancer patients. Multivariate analysis of independent prognostic factors for survival of vulvar cancer patients yielded lymph node status, adjuvant radiotherapy and chemotherapy as positive prognostic factors.
Topics: Carcinoma, Squamous Cell; Female; Humans; Lymph Node Excision; Lymphatic Metastasis; Neoplasm Staging; Prognosis; Retrospective Studies; Vulvar Neoplasms
PubMed: 34588718
DOI: 10.20471/acc.2021.60.01.04 -
Journal of the Egyptian National Cancer... Jun 2017
Topics: Female; Humans; Incidence; Neoplasm Grading; Neoplasm Staging; Rare Diseases; Vulvar Neoplasms
PubMed: 28462851
DOI: 10.1016/j.jnci.2017.04.002