Vulvar cancer pathophysiology

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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.

Sign out

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).