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Pathology -Vulvar carcinoma
Definition • A malignant epithelial neoplasm originating in the vulva.
Epidemiology: Rare, having a yearly incidence of 0.8 per 100,000 individuals. • Predominantly occurs in elderly women, though it may sometimes manifest in younger women.
Aetiology • Often unidentified in numerous instances. • Certain occurrences are associated with chronic vulval dermatoses, including lichen sclerosus and lichen planus. • The majority of instances occurring in younger women are correlated with high-risk HPV infection of the vulva.
Carcinogenesis • The majority of instances originate from a precursor lesion
identified as vulval intraepithelial neoplasia (VIN). VIN is a dysplastic lesion of the vulvar squamous epithelium, categorized into two types: classical and differentiated. The classical type is observed in young women and is associated with HPV infection. The differentiated type is observed in older women and is associated with chronic vulvar inflammation. Both VIN and vulval carcinomas exhibit genetic anomalies, including mutations in TP53 and PTEN.
Presentation • The majority present with a vulvar tumor that may undergo ulceration and hemorrhage.
Macroscopy • A vulvar tumor mass that may present as nodular, verrucous, or ulcerated. Histopathology • The majority of cases are squamous cell carcinomas, characterized by infiltrating malignant epithelial cells exhibiting squamous differentiation. • The squamous epithelium next to the tumor may demonstrate vulvar intraepithelial neoplasia (VIN).
Prognosis • The primary prognostic factors are tumor size, invasion depth, and the degree of lymph node metastasis. Tumors with a depth of invasion of 1 mm exhibit a little risk of lymph node metastasis and a favorable prognosis for cure following local excision. The 5-year survival rate for people with unilateral lymph node disease is 65%, but it decreases to 25% for those with bilateral disease.
Definition • A malignant epithelial neoplasm originating in the vulva.
Epidemiology: Rare, having a yearly incidence of 0.8 per 100,000 individuals. • Predominantly occurs in elderly women, though it may sometimes manifest in younger women.
Aetiology • Often unidentified in numerous instances. • Certain occurrences are associated with chronic vulval dermatoses, including lichen sclerosus and lichen planus. • The majority of instances occurring in younger women are correlated with high-risk HPV infection of the vulva.
Carcinogenesis • The majority of instances originate from a precursor lesion
identified as vulval intraepithelial neoplasia (VIN). VIN is a dysplastic lesion of the vulvar squamous epithelium, categorized into two types: classical and differentiated. The classical type is observed in young women and is associated with HPV infection. The differentiated type is observed in older women and is associated with chronic vulvar inflammation. Both VIN and vulval carcinomas exhibit genetic anomalies, including mutations in TP53 and PTEN.
Presentation • The majority present with a vulvar tumor that may undergo ulceration and hemorrhage.
Macroscopy • A vulvar tumor mass that may present as nodular, verrucous, or ulcerated. Histopathology • The majority of cases are squamous cell carcinomas, characterized by infiltrating malignant epithelial cells exhibiting squamous differentiation. • The squamous epithelium next to the tumor may demonstrate vulvar intraepithelial neoplasia (VIN).
Prognosis • The primary prognostic factors are tumor size, invasion depth, and the degree of lymph node metastasis. Tumors with a depth of invasion of 1 mm exhibit a little risk of lymph node metastasis and a favorable prognosis for cure following local excision. The 5-year survival rate for people with unilateral lymph node disease is 65%, but it decreases to 25% for those with bilateral disease.
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