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2011, Número 4

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Arch Med Actual Trac Gen Inf 2011; 3 (4)


Neoplasia Intraepitelial Vulvar

Gay PE

Idioma: Español
Referencias bibliográficas: 43
Paginas: 15-24
Archivo PDF: 136.25 Kb.


RESUMEN

La incidencia de neoplasia intraepitelial vulvar (NIV) asociadas con el virus del papiloma humano (VPH) está aumentando en todo el mundo. Al considerar sólo las mujeres con 50 años o menos, se observó que la incidencia de la NIV se ha incrementado 392%, mientras que el de carcinoma invasor sólo aumentó en 157%, lo que fue interpretado como una consecuencia previsible de la transformación neoplásica de NIV. La NIV fue descrita por Bowen en 1912, quien reportó grandes lesiones perianales que se extienden lateralmente y la histología asociadas de carcinoma de células escamosas in situ. No fue hasta 1986 que recomendó el uso de la terminología ISSVD: VIN (NIV), en sustitución de la clasificación de 1976. De acuerdo con la naturaleza biológica de la lesión, la NIV se puede dividir en dos grandes grupos, cada uno posee sus propias características. No hay signos clínicos específicos o síntomas de lesiones VIN, por lo que el diagnóstico es histológico. Existen pruebas morfológicas y clínicas de que la NIV tiene el potencial de progresión a cáncer invasor y, más raramente, de regresión. Los tratamientos actuales que son efectivos y que no distorsionan la anatomía normal, se consideran cada vez más. Sólo la vacuna cuadrivalente está aprobada para la protección contra las lesiones precancerosas y el cáncer de la vulva y vagina. En conclusión, el tratamiento de la VIN se basa en un conocimiento amplio de la historia natural de esta enfermedad y la necesidad de controlar los síntomas.


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