New aspects of vulvar cancer: Changes in localization and age of onset

Hampl, Monika; Deckers-Figiel, S.; Hampl, Juergen A.; Rein, Daniel T.; Bender, Hans

doi:10.1016/j.ygyno.2008.01.041

Cited by 155 publications

(93 citation statements)

References 17 publications

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“…Cases of young women with anterior VIN III lesions or invasive carcinoma located between the clitoris and the urethra have been seen in increasing numbers within the last years in our referral center for vulvar disease [7] . The nonkeratinizing squamous epithelium in this location seems to be more sensitive to HPV infection compared to the keratinized, squamous epithelium of the vulvar skin.…”

Section: Discussionmentioning

confidence: 99%

Single Large Inguinal Lymph Node Metastasis in Human Papillomavirus-Induced Early Invasive Vulvar Cancer of the Anterior Fourchette in Two Young Women

Hampl

Kueppers²

2008

Gynecol Obstet Invest

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The incidence of human papillomavirus (HPV)-induced vulvar cancer in young women is increasing and often presents as microinvasive or early invasive tumors in a grade 3 vulvar intraepithelial neoplasia. So far, the risk of lymph node metastases in early invasive vulvar carcinoma (depth of invasion 1.1–2.0 mm) is reported to be less than 8%. We present 2 cases of young women with early invasive vulvar cancers (depth of invasion 1.5 and 2.0 mm) induced by HPV 16 and 42. In both cases, the cancers are located between the clitoris and urethra and are each accompanied by one groin macro-metastatic lymph node. This case report highlights the necessity for complete inguinofemoral lymphadenectomy and/or adequate radiation therapy of the groin in early invasive tumors in young women to prevent cancer recurrence in the groin. Additionally, the indication for a sentinel node procedure in these specific cases requires particular caution.

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Section: Discussionmentioning

confidence: 99%

Single Large Inguinal Lymph Node Metastasis in Human Papillomavirus-Induced Early Invasive Vulvar Cancer of the Anterior Fourchette in Two Young Women

Hampl

Kueppers²

2008

Gynecol Obstet Invest

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“…Sie ist charakterisiert durch den Nachweis von 7 High-risk-HP-Viren in bis zu 90% der Fälle und einem Auftreten bei jungen Frauen [7]. Vorherrschend ist der onkogene Typ HPV-16 (in 80%), gefolgt von HPV-33 mit etwa 10% ( [8,9]; . Tab.…”

Section: Histologie Und Klassifikationunclassified

“…Abb. 5) und nicht selten erst im invasiven Stadium diagnostiziert werden[9].Diedifferenzierte VIN ist schwer zu erkennen. Sie imponiert meist als rötliche Hautveränderung, die vorgeschädigte Haut ist sehr dünn, und erst nach Essigapplikation wird die Verdachtsdiagnose des Vorliegens einer Präneoplasie gestellt (.…”

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Vulväre Präkanzerosen

2011

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“…The incidence of vulvar carcinoma, however, has recently increased among younger women; thus, there may have been an increase in pregnancy rates following vulvar carcinoma treatment (1). Pregnant women who undergo surgical treatment for vulvar carcinoma, including radical vulvectomy, may have an increased incidence of caesarean delivery (2).…”

Section: Introductionmentioning

confidence: 99%

Pregnancy and cesarean delivery after multimodal therapy for vulvar carcinoma: A case report

Toriyabe

Taniguchi

Senda

et al. 2016

Molecular and Clinical Oncology

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Abstract. Reports of pregnancy following treatment for vulvar carcinoma are extremely uncommon, as the main problem of subsequent pregnancy is vulvar scarring following radical surgery. We herein report the case of a patient who was diagnosed with stage I squamous cell carcinoma of the vulva at the age of 17 years and was treated with multimodal therapy, including neoadjuvant chemotherapy, wide local excision with bilateral inguinal lymph node dissection and adjuvant radiotherapy. The patient became pregnant spontaneously 9 years after her initial diagnosis and the antenatal course was good, except for mild acute pyelonephritis at 25 weeks of gestation. An elective caesarean section was performed at 38 weeks of gestation due to vulvar scarring following multimodal therapy, particularly radiotherapy. The patient remains alive and well, without signs of recurrence or metastasis 12 years after her diagnosis and treatment. Radical vulvectomy as well as multimodal therapy for vulvar carcinoma, particularly radiotherapy, may cause extensive skin scarring. The presence of vulvar scarring following multimodal therapy for vulvar carcinoma may increase the incidence of caesarean delivery. IntroductionAs carcinoma of the vulva is rare among young women, reports of pregnancy following treatment for vulvar carcinoma are extremely uncommon. The incidence of vulvar carcinoma, however, has recently increased among younger women; thus, there may have been an increase in pregnancy rates following vulvar carcinoma treatment (1). Pregnant women who undergo surgical treatment for vulvar carcinoma, including radical vulvectomy, may have an increased incidence of caesarean delivery (2). In the literature, vulvar scarring following radical vulvectomy was the major reason for pregnant women undergoing caesarean section (2-7). To date, no cases of pregnancy following vulvar carcinoma have been reported in patients who had undergone surgery and radiotherapy.We herein describe a case in which caesarean section was performed due to the presence of extensive vulvar scarring following multimodal therapy for vulvar carcinoma, including chemotherapy, surgery and radiotherapy. Case reportIn April, 2003, a 17-year-old, nulligravida Japanese woman, who was a smoker, presented with a 4-month history of a mass (sized >2 cm) with accompanying pruritus in the left labium majus (Fig. 1). Examination of biopsy specimens revealed invasive squamous cell carcinoma with keratin pearl formation and stromal invasion >1 mm in depth (Fig. 2). Screening for sexually transmitted infections, including HIV serology, syphilis serology, Chlamydia trachomatis polymerase chain reaction and Neisseria gonorrhoeae polymerase chain reaction were performed, and were all negative. The serum squamous cell carcinoma antigen level was 2.6 ng̸ml (normal value, <1.5 ng̸ml). Magnetic resonance imaging (MRI) revealed enlarged inguinal lymph nodes bilaterally. The patient first underwent neoadjuvant chemotherapy (pepleomycin, 5 mg̸body intramuscular injection twice a week for 2.5 we...

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New aspects of vulvar cancer: Changes in localization and age of onset

Cited by 155 publications

References 17 publications

Single Large Inguinal Lymph Node Metastasis in Human Papillomavirus-Induced Early Invasive Vulvar Cancer of the Anterior Fourchette in Two Young Women

Single Large Inguinal Lymph Node Metastasis in Human Papillomavirus-Induced Early Invasive Vulvar Cancer of the Anterior Fourchette in Two Young Women

Vulväre Präkanzerosen

Pregnancy and cesarean delivery after multimodal therapy for vulvar carcinoma: A case report

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