Vulvar cancer pathophysiology: Difference between revisions
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Overview | Overview | ||
Most common malignancies of vulva: | Most common malignancies of vulva: | ||
Invasive squamous cell carcinoma. | Invasive squamous cell carcinoma. | ||
Malignant melanoma. | Malignant melanoma. | ||
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Vulvar squamous cell carcinoma | Vulvar squamous cell carcinoma | ||
===General=== | |||
General | |||
Most common vulvar malignancy. | Most common vulvar malignancy. | ||
Precursor lesions for SCC | Precursor lesions for SCC | ||
Vulvar intraepithelial neoplasia (VIN). | Vulvar intraepithelial neoplasia (VIN). | ||
VIN can be divided into: | VIN can be divided into: | ||
Classic VIN, and | Classic VIN, and | ||
Differentiated VIN. | Differentiated VIN. | ||
Differentiated VIN is mostly irrelevant as it is basically never seen alone, i.e. it usually accompanies cancer. | Differentiated VIN is mostly irrelevant as it is basically never seen alone, i.e. it usually accompanies cancer. | ||
Low grade pre-cancerous lesions (VIN) are typically HPV positive, while high grade pre-cancerous lesions and cancer are less often HPV positive.[13] | Low grade pre-cancerous lesions (VIN) are typically HPV positive, while high grade pre-cancerous lesions and cancer are less often HPV positive.[13] | ||
Microscopic | ====Microscopic=== | ||
Like SCC elsewhere. | Like SCC elsewhere. | ||
Microinvasion: <=1 mm stromal invasion, tumour size <=2 cm (T1a).[14] | Microinvasion: <=1 mm stromal invasion, tumour size <=2 cm (T1a).[14] | ||
Depth from DE junction. | Depth from DE junction. |
Revision as of 14:15, 18 September 2015
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Malignant neoplasms of the vulva
Overview
Most common malignancies of vulva: Invasive squamous cell carcinoma. Malignant melanoma.
Vulvar squamous cell carcinoma
General
Most common vulvar malignancy. Precursor lesions for SCC Vulvar intraepithelial neoplasia (VIN). VIN can be divided into: Classic VIN, and Differentiated VIN. Differentiated VIN is mostly irrelevant as it is basically never seen alone, i.e. it usually accompanies cancer. Low grade pre-cancerous lesions (VIN) are typically HPV positive, while high grade pre-cancerous lesions and cancer are less often HPV positive.[13]
=Microscopic
Like SCC elsewhere. Microinvasion: <=1 mm stromal invasion, tumour size <=2 cm (T1a).[14] Depth from DE junction.
Note:
Tumour thickness != depth of invasion. Thickness = granular layer or surface (no granular layer present) to deepest tumour. Depth of invasion = epithelial-stromal junction in "valley" of papillae.
DDx:
Classic vulvar intraepithelial neoplasia - esp. tangential sections. Differentiated vulvar intraepithelial neoplasia.
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VULVA, LEFT SIDE, (INCISIONAL) BIOPSY: - INVASIVE SQUAMOUS CELL CARCINOMA. -- PLEASE SEE TUMOUR SUMMARY.
TUMOUR SUMMARY - VULVA Specimen Size: multiple fragments - up to 2.5 cm in aggregate. Tumour site: left vulva - around Bartholin's gland. Tumour size: at least 10 mm, cannot be determined due to fragmentation. Tumour focality: cannot be determined. Histologic type: squamous cell carcinoma with focal keratinization. Histologic Grade: G2 - moderately differentiated. Microscopic tumour extension: greater than 2 mm, assessment limited by
fragmentation and tissue orientation.
Tumour border: infiltrating. Lymph-Vascular Invasion: present. Additional findings:
Vulvar intraepithelial neoplasia (VIN) 3 (severe dysplasia/carcinoma in situ).