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