Objective: To describe the clinical impact of PET/CT in the management of patients with vulvar cancer.
Material And Methods: Retrospective analysis of 13 PET/CT studies with (18)F-FDG (6 staging and 7 suspected recurrence) corresponding to 10 patients diagnosed with vulvar cancer by biopsy, with a mean age of 64.5 years. The preoperative PET/CT study was analyzed qualitatively according to the lesion region. Surgical excision was carried out, covering all the suspected areas according to the PET/CT study. This was compared with the histopathologic analysis.
Results: Abnormal vulvar PET/CT uptake was found in 9 out of the 13 studies and invasion of adjacent structures in 5 of them (urethra, perineal, vagina). The inguinal-femoral lymph nodes were considered as affected in 3 studies and one pelvic lymph node was also affected. Four of the studies had extralymphatic involvement: 3 in lung and 1 in ischiorectal fossa. The PET/CT showed a 100% sensitivity for the detection of the vulvar lesion in squamous cell carcinomas and 60% in non-squamous cell ones. There was a false positive result for local invasion due to urine contamination. One of the studies with lung metastases was related to a synchronous breast tumor. All the pathological lymph node levels detected in the PET/CT study were confirmed in the histopathology study. No new lesions were identified by surgery. PET/CT changed the therapeutic management in 8/13 studies (61.5%).
Conclusions: PET/CT is postulated as a useful imaging test for the management of vulvar cancer, mainly in the identification of nodal metastases. It may affect both surgical planning and clinical management. Larger series are needed to confirm our findings.
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http://dx.doi.org/10.1016/j.remn.2013.07.009 | DOI Listing |
Int J Gynecol Cancer
January 2025
Hacettepe University, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Ankara, Turkey.
Background: Vulvar squamous cell carcinoma incidence is increasing, especially among women under 60, largely attributed to human papillomavirus infections. Precursor pre-invasive vulvar lesions are frequently underdiagnosed. Routine vulvar inspection during cervical cancer screening could offer an opportunity for the detection of these lesions.
View Article and Find Full Text PDFInfect Agent Cancer
January 2025
Shahid Beheshti University of Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.
Both women and men are now confronted with the grave threat of cancers caused by the human papillomavirus (HPV). It is estimated that 80% of women may encounter HPV over their lives. In the preponderance of cases involving anal, head and neck, oral, oropharyngeal, penile, vaginal, vulvar, and cervical malignancies, high-risk HPV (HR-HPV) is the causative agent.
View Article and Find Full Text PDFAnn Hematol
January 2025
Department of Obstetrics and Gynecology, The Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.
Chronic Graft-versus-host disease (GVHD) is a major complication of allogeneic hematopoietic stem cell transplantation (HSCT), affecting the female genital tract in 25-66% of the patients. This condition, referred to as Genital GVHD is an underdiagnosed gynecologic comorbidity, that can significantly impair quality of life. We aimed to describe the prevalence and management of genital GVHD following HSCT.
View Article and Find Full Text PDFInt J Gynecol Pathol
January 2025
Diagnostic Pathology, National Cancer Center Hospital.
Vulvar adenocarcinoma of the intestinal type (VAIt) is a rare subtype of primary vulvar carcinoma, with ∼30 cases documented in the English literature. This study presents 2 new cases of HPV-independent VAIt with lymph node metastasis and discusses their clinical presentation, histopathologic features, and whole exome sequencing (WES) analysis. Both cases exhibited histologic features consistent with VAIt, including tubular, papillary, and mucinous carcinoma components.
View Article and Find Full Text PDFMod Pathol
January 2025
Department of Pathology and Laboratory Medicine, University of Miami.
Human papillomavirus (HPV) underpins approximately 90% of squamous cell carcinomas (SCC) of the anus and perianal region. These tumors usually arise in association with precursor lesions such anal intraepithelial neoplasia/ high-grade squamous intraepithelial lesion (AIN 3/ HSIL), whereas a small subset of HPV-negative cancers may harbor mutations in TP53. Recently, vulvar lesions termed differentiated exophytic vulvar intraepithelial lesion/vulvar acanthosis with altered differentiated (DEVIL/VAAD) have been recognized as HPV-independent, TP53 wild-type precursors for vulvar carcinoma; however, analogous anal lesions have not been described.
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