Detection of Precancerous Lesions of the Vulva
Vulvar cancer and its precursor lesions are uncommon and hence there are no standard screening programs. The precancerous lesions are often overlooked and are treated as nonspecific dermatologic conditions. Often the patients seek multiple opinions from different specialists for symptom relief. Therefore, the gynecologists, dermatologists, and other healthcare providers in this field should be familiar of the clinical features and detection of the different premalignant vulvar lesions: squamous vulvar intraepithelial neoplasia, vulvar Paget disease, and melanoma in situ. The histopathological diagnosis can sometimes be mistaken especially in differentiated vulvar intraepithelial neoplasias, and a close relationship between clinicians and the pathologists will help to arrive at the correct diagnosis and proper management.
KeywordsVIN HSIL dVIN EMPD MIS Precancerous lesions of the vulva Vulvar Paget disease Vulvoscopy Collins test
- 4.Van de Nieuwenhof HP, Bulten J, Hollema H, Dommerholt RG, Massuger LF, van der Zee AG, et al. Differentiated vulvar intraepithelial neoplasia is often found in lesions, previously diagnosed as lichen sclerosus, which have progressed to vulvar squamous cell carcinoma. Mod Pathol. 2010;24(2):297–305.PubMedCrossRefGoogle Scholar
- 12.van Beurden M, ten Kate FJ, Smits HL, Berkhout RJ, de Craen AJ, van der Vange N, et al. Multifocal vulvar intraepithelial neoplasia grade III and multicentric lower genital tract neoplasia is associated with transcriptionally active human papillomavirus. Cancer. 1995;75:2879–84.PubMedCrossRefGoogle Scholar
- 28.Kurman RJ, Toki T, Schiffman MH. Basaloid and warty carcinomas of the vulva: distinctive types of squamous cell carcinoma frequently associated with human papillomaviruses. Am J Surg Pathol. 1993;17:133e45.Google Scholar
- 31.van der Avoort IA, van der Laak JA, Paffen A, Grefte JM, Massuger LF, de Wilde PC, et al. MIB1 expression in basal cell layer: a diagnostic tool to identify premalignancies of the vulva. Mod Pathol. 2007;20:770Y8.Google Scholar
- 32.Yang B, Hart WR. Vulvar intraepithelial neoplasia of the simplex (differentiated) type: a clinicopathologic study including analysis of HPV and p53 expression. Am J Surg Pathol. 2000;24:429Y41.Google Scholar