On the basis of our clinical experience and a careful revision of the literature, we have attempted to identify the natural history of vulvar carcinoma by verifying the real evolutive possibility of these lesions, their possible genesis, the latent period between pre-invasive and invasive forms, and some events which seem to play a significant role in the onset of the invasive form in this period. These considerations indicate a new clinical and study approach to carcinoma in situ, which would thus become a pathology characterized by a more precise pathogenetic and evolutive individuality.
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Int 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 PDFInt J Gynecol Pathol
January 2025
Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts.
The term verruciform acanthotic vulvar intraepithelial neoplasia (vaVIN) was coined to describe HPV-independent p53-wildtype lesions with characteristic clinicopathologic characteristics and association with vulvar squamous cell carcinoma (vSCC). We aimed to expand on the molecular landscape of vaVIN using comprehensive sequencing and copy number variation profiling. vaVIN diagnosis in institutional cases was confirmed by a second review, plus negative p16 and wildtype p53 by immunohistochemistry.
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.
View Article and Find Full Text PDFLife (Basel)
December 2024
Department of Dermatology, Hospital Universitario San Cecilio, Avenida del Conocimiento s/n, 18016 Granada, Spain.
Vulvar cancer, particularly squamous cell carcinoma (SCC) and melanoma, poses significant diagnostic and therapeutic challenges due to its complex presentation and high rates of postoperative complications. Effective management requires a multidisciplinary approach, integrating the expertise of gynecologic oncologists, dermatologists, plastic surgeons, and other specialists. This review highlights the dermatologist's role in supporting early diagnosis, addressing predisposing conditions such as lichen sclerosus, and managing postoperative wound complications, including surgical site infections and dehiscence.
View Article and Find Full Text PDFCancers (Basel)
January 2025
Clinic of Obstetrics and Gynecology, "Santa Maria della Misericordia" University Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, Italy.
Background: Vulvar carcinoma is an uncommon gynecological tumor primarily affecting older women. Its treatment significantly impacts the quality of life and, not least, aesthetics because of the mutilating surgery it requires.
Objectives: The management requires a multidisciplinary team of specialists who know how to care for the patient in her entirety, not neglecting psychological aspects and reconstructive surgery.
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