The relationship of chronic vulvar disease, leukoplakia, and carcinoma in situ to carcinoma of the vulva

Vulvar Lichen Sclerosus and Neoplastic Transformation

“…However, nearly all of the studies published before the 1975 ISSVD classification of vulvar distrophies 4 contain data that are unusable, because they use poorly defined terminology (such as leukoplakia, kraurosis, dystrophy) and lack uniform diagnostic criteria for lichen sclerosus. [5][6][7][8][9][10] The 1975 ISSVD classification of vulvar distrophies introduced VLS as a separate entity with clearly defined clinical and histological features. 4 In the studies after 1975, the mean incidence risk of developing neoplasia in women with VLS is 2.8%.…”

Premalignant Conditions of the Vulva, with Particular Reference to Chronic Epithelial Dystrophies

“…Historically and etymologically the latter is right. Neverthe'ess, some clinicianand pathologists (Wallace and Whimster, 1951;Waiiace, 1955 ;McAdams and Kistner, 1958) now restrict the diagnosis of leucoplakia to those vulvas which, irrespective of their naked-eye appearances, show on section such a degree of disorderly epithelial activity (" atypism ") as to make it approximate to malignant change (Special Plate, Figs. 3 and 4).…”

“…Such discharges sometimes cause condylomata acuminata, which in the past were regarded as precancerous (Taussig, 1931(Taussig, , 1940. Though Stening and Elliott (1959) reported that cancer in four of their cases was superimposed on "papillomatous warts," most modern findings are opposed to the concept that condylomata can become malignant (McAdams and Kistner, 1958). Older reports to the contrary were probably based either on confusion between the histological appearances of condylomata and of cancer, or on the assumption that a papillomatous pattern of squamous carcinoma implies that an innocent papilloma has become malignant.…”

“…Older reports to the contrary were probably based either on confusion between the histological appearances of condylomata and of cancer, or on the assumption that a papillomatous pattern of squamous carcinoma implies that an innocent papilloma has become malignant. Similarly, there is no convincing evidence to support an older impression that syphilitic and tuberculous lesions of the vulva can determine the development of cancer (Lunin, 1949;Stening and Elliott, 1959;McAdams and Kistner, 1958). Chronic inflammatory disease, especially if accompanied by hypertrophic tissue reactions, can simulate cancer both macroscopically and microscopically; this fact also makes it difficult to decide whether granuloma inguinale and lymphogranuloma can lead to epithelioma of the vulva.…”

“…Nevertheless McAdams and Kistner (1958), in their prospective study of seven women with vulval granuloma, did not encounter one case of cancer, so the matter remains unsettled. Age Squamous-cell cancer of the vulva, like skin cancer at any site, is a disease of old age.…”