IMR Press / EJGO / Volume 19 / Issue 1 / pii/1998106

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on as a courtesy and upon agreement with S.O.G.

Original Research

Analysis of alterations adjacent to invasive vulvar carcinoma and their relationship with the associated carcinoma: a study of 67 cases

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1 Department of Dermatology, Centre René Huguenin, Saint-Cloud, France
2 Department of Dermatology, H?pital Saint-Louis (Prof Dubertret), France
3 Department of Statistics, Centre René Huguenin, Saint-Cloud, France
4 Department of Pathology, Centre René Huguenin, Saint-Cloud, France
Eur. J. Gynaecol. Oncol. 1998, 19(1), 25–31;
Published: 10 February 1998

A retrospective analysis of histological lesions adjacent to 67 invasive vulvar squamous cell carcinomas (SCC) was undertaken to analyse their nature, as well as their relationship to SCC. Patient age, clinical presentation and histological type of carcinoma, ISSVD classification of its adjacent lesions, disease-free and overall survival were reviewed. Severe undifferentiated vulvar intra-epithelial neoplasia (VIN3) was found in 19.4% of cases and vulvar lichen sclerosus (VLS) in 76.1 % of cases. All VLS, except 2 cases, were associated with squamous cell hyperplasia (SCH), and a concomitant differentia­ted VIN was found in 76.6% of cases. Undifferentiated VIN3 was never associated with VLS. VLS was significantly associated with a keratinizing, well-differentiated SCC (98% of cases), while undifferentiated VIN3, was linked preferentially to 2 other types of SCC: in 77% of cases, a moderately-differentiated SCC with the same histological features as the so-called basaloid carcinoma and, in 23% of cases, a well-differentiated SCC with a variable extent of koilocytic atypia, similar to the so-called warty carcinoma. Car­cinoma of the fourchette was more often associated with undifferentiated VIN3. Diseasefree and overall survival were significantly better for carcinoma associated with undifferentiated VIN3 (p < 0.01 and p < 0.05, respectively). These findings suggest invasive vulvar SCC occurs on 2 distinct types of vulvar lesions: differentiated VIN and/or SCH associated with VLS and undifferentiated VIN3. Furthermore, the histological type of the carcinoma seems to differ according to adjacent lesions.

Vulvar carcinoma
Differentiated VIN
Undifferentiated VIN
Lichen sclerosus
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