VIN Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):371-376
DOI 10.1590/S0100-72031998000700001
The purpose of the present study was to evaluate some epidemiological, clinical and pathological characteristics of the different grades of vulvar intraepithelial neoplasia (VIN), and its relation with the presence of human papillomavirus (HPV). The charts of 46 women with VIN, examined from 1986 through 1997, were reviewed. For statistical analysis the chi² with yates correction when appropriate, and Fisher's exact tests were used. Regarding the grade of VIN, six women presented VIN 1, six others had VIN 2 and the remaining 34 presented VIN 3. All women presented similar characteristics such as age, menstrual status and age at first sexual intercourse. Women with more than one lifetime sexual partner had a tendency to show more VIN 3 (p = 0.090). Cigarette smoking was significantly associated with the severity of the vulvar lesion (p = 0.031). HPV was significantly more frequent in women younger than 35 years of age (p = 0.005) and in women with multiple lesions (p = 0.089). Although the number of lesions were not related to the severity of VIN (p = 0.703), lesions with extensions greater than 2 cm were significantly associated with VIN 3 (p = 0.009). The treatment of choice for VIN 3 was surgery, including local resection and simple vulvectomy. Eight women relapsed, and only one had VIN 2. We concluded that among women with VIN, cigarette smoking and more than one lifetime sexual partner were associated with high-grade lesions. HPV was more frequent among patients younger than 35 years of age presenting multiple lesions. Women with VIN 3 presented lesions bigger than 2 cm and a high relapse rate, despite the type of treatment applied.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):371-376
DOI 10.1590/S0100-72031998000700001
The purpose of the present study was to evaluate some epidemiological, clinical and pathological characteristics of the different grades of vulvar intraepithelial neoplasia (VIN), and its relation with the presence of human papillomavirus (HPV). The charts of 46 women with VIN, examined from 1986 through 1997, were reviewed. For statistical analysis the chi² with yates correction when appropriate, and Fisher's exact tests were used. Regarding the grade of VIN, six women presented VIN 1, six others had VIN 2 and the remaining 34 presented VIN 3. All women presented similar characteristics such as age, menstrual status and age at first sexual intercourse. Women with more than one lifetime sexual partner had a tendency to show more VIN 3 (p = 0.090). Cigarette smoking was significantly associated with the severity of the vulvar lesion (p = 0.031). HPV was significantly more frequent in women younger than 35 years of age (p = 0.005) and in women with multiple lesions (p = 0.089). Although the number of lesions were not related to the severity of VIN (p = 0.703), lesions with extensions greater than 2 cm were significantly associated with VIN 3 (p = 0.009). The treatment of choice for VIN 3 was surgery, including local resection and simple vulvectomy. Eight women relapsed, and only one had VIN 2. We concluded that among women with VIN, cigarette smoking and more than one lifetime sexual partner were associated with high-grade lesions. HPV was more frequent among patients younger than 35 years of age presenting multiple lesions. Women with VIN 3 presented lesions bigger than 2 cm and a high relapse rate, despite the type of treatment applied.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):329-335
DOI 10.1590/S0100-72032004000400011
Extramammary Paget's disease (EPD) is an uncommon neoplasic condition observed mostly in areas with numerous apocrine and or eccrine glands. In the woman it is most commonly seen on the vulva, although it can occur in other locations. Vulvar Paget's disease (VPD) can be classified into primary, of cutaneous origin, and secondary, of extracutaneous origin, with significant clinical e prognostic implications. Clinically VPD begins insidiously with pruritus and burning sensation. The lesion appears as a solitary patch with an eczematous, erythematous and squamous surface. This is a report of a case of a 72-year-old patient with an erythematous slightly thickened patch lesion with spots of erosion involving both the right and the left majus and minus labia, the clitoris, the pubic region, and the perineal and perianal regions. The operation performed included radical vulvectomy and bilateral inguinal lymphadenectomy. The histopathology revealed invasive Paget's disease. Immunohistochemical methods showed positive Paget cells for CEA, EMA, and cytokeratin pan. Pathogenesis and diagnosis of EPD is discussed, with differential diagnosis and reference to immunohistochemical methods. Recurrence rate is 30%, even with margin control. Experience with EPD is limited and long-term follow-up is required to exclude recurrence of the disease and development of an associated cancer.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):329-335
DOI 10.1590/S0100-72032004000400011
Extramammary Paget's disease (EPD) is an uncommon neoplasic condition observed mostly in areas with numerous apocrine and or eccrine glands. In the woman it is most commonly seen on the vulva, although it can occur in other locations. Vulvar Paget's disease (VPD) can be classified into primary, of cutaneous origin, and secondary, of extracutaneous origin, with significant clinical e prognostic implications. Clinically VPD begins insidiously with pruritus and burning sensation. The lesion appears as a solitary patch with an eczematous, erythematous and squamous surface. This is a report of a case of a 72-year-old patient with an erythematous slightly thickened patch lesion with spots of erosion involving both the right and the left majus and minus labia, the clitoris, the pubic region, and the perineal and perianal regions. The operation performed included radical vulvectomy and bilateral inguinal lymphadenectomy. The histopathology revealed invasive Paget's disease. Immunohistochemical methods showed positive Paget cells for CEA, EMA, and cytokeratin pan. Pathogenesis and diagnosis of EPD is discussed, with differential diagnosis and reference to immunohistochemical methods. Recurrence rate is 30%, even with margin control. Experience with EPD is limited and long-term follow-up is required to exclude recurrence of the disease and development of an associated cancer.
