Basal Cell Carcinoma of the Vulva

Abstract

Basal cell carcinoma was found in eight of 61 cases of vulvar malignancy occurring over a 20-year period. This incidence of basal cell carcinoma was 13.1%, higher than the expected 2%-5% reported previously in the literature. Symptoms of a mass, usually discharge, pruritus or bleeding, were commonly ignored for long periods of time by the elderly patient. The specific location and size were difficult to ascertain from hospital records. Therapy is always surgical with wide local excision recommended. Local recurrence will be noted in 10%-20%, as vulvar basal cell carcinoma is a multicentric lesion and, therefore, long-term follow-up, as with any malignancy, is mandatory. Adequate identification and reporting may well show that this lesion is more common than has been previously thought.

Basal cell carcinoma of the vulva

“…This incidence is higher than the expected 2-3% reported in most previous studies [1,[3][4][5][6][8][9][10]12,13]. Nevertheless, some studies have shown that the relative frequency ranges from 0.8 to 14.7% [2,7,11].…”

“…Careful histologic evaluation of the biopsy material is necessary to rule out a malignant squamous component [10,11]. In this series, however, histopathologic examination of the biopsy and surgical specimens demonstrated that all tumors were pure forms of BCC without keratinization or squamous cell component.…”

“…In this series, however, histopathologic examination of the biopsy and surgical specimens demonstrated that all tumors were pure forms of BCC without keratinization or squamous cell component. Vulvar BCCs containing squamous element within the neoplastic growth (basosquamous carcinoma) exhibit a more aggressive behavior with propensity of the malignant squamous component to metastasize [10,11]. In contradistinction to squamous cell carcinoma and basosquamous carcinoma of the vulva, pure forms of BCC of the vulva hardly ever metastasize.…”

“…Although Jews of Asian-African origin (Sephardic) make up about 60% of the Jewish population in the south of Israel, we have noticed more Jewish women of European-American origin (Ashkenazi) (6/8) than those of Asian-African origin (Sephardic) (2/8) affected by vulvar BCC. Studies from the USA have shown that vulvar BCC is more prevalent in Caucasian women than in Black women [2,4,10,11].…”

“…The etiology of vulvar BCC is unknown. Syphilis, chronic irritation, chronic infection, trauma, arsenicals, and prior radiotherapy have been implicated as possible precipitating factors in the development of vulvar BCC; but there seems to be no recognizable association at present [6,11,13]. In contradistinction to vulvar squamous cell carcinoma, leukoplakia is not a predisposing condition [11,12].…”