2005, Number 11
<< Back Next >>
Ginecol Obstet Mex 2005; 73 (11)
Vulvar intraepithelial neoplasm
Madrigal DMA, Ruíz MJA, Palacios OJ
Language: Spanish
References: 20
Page: 573-578
PDF size: 65.54 Kb.
ABSTRACT
Background: Vulvar intraepithelial neoplasia is a challenge for the physician as it is asymptomatic and it can evolve to malignant disease. A high suspicion index, as well as some biopsies are necessary, provided an early invasive disease can exist.
Objective: To establish the patient’s characteristics with vulvar intraepithelial neoplasia, seen at the Clínica de Especialidades de la Mujer, SEDENA.
Patients and methods: An observational and retrospective analysis was done from February 1st, 1990 to December 31st, 2004. We used the data base of the Hospital Central Militar and of the Clínica de Especialidades de la Mujer, SEDENA. We identified patients with vulvar intraepithelial neoplasia or in situ vulvar cancer diagnosis. We assessed the following variables: patient’s age, intraepithelial neoplasia or history of cervical cancer, acuminated vagina or condylomas, prescribed treatment and current health state.
Results: We identified 38 patients with ages between 49 and 82 years old. Patients with intraepithelial neoplasia I were the youngest, except one, whom at the moment of the diagnosis had 58 years old. The histopathological diagnosis was of intraepithelial neoplasia type I (koilocytotic atypia) in 10 cases, type II in 10 more, and type III in 18 of them.
Conclusions: Treatment should be individual for each patient. In most of the cases and due to the high recurrence rates we prefer the conservative treatments.
REFERENCES
Ridley CM, Frankman O, Wilkinson E. New nomenclature for vulvar disease. Report of the Committee on Terminology. ISSVD. Int J Gynecol Pathol 1989;8:83.
Aho M, Esterinen E, Meyer B, et al. Natural history of vaginal intraepithelial neoplasia. Cancer 2005;68:195-7.
Ferenzcy A. Intraepithelial neoplasia of the vulva. Gynecol Oncol 1992;26:443.
Barbero M, Micheletti L, Preti M, et al. Biologic behavior of vulvar intraepithelial neoplasia. J Reprod Med 2005;38:108-12.
Ruiz Moreno JA, García GR. Resultados de un programa selectivo de detección de neoplasia intraepitelial de la vulva. Ginecol Obstet Mex 1992;60:55-59.
Gupta J, Pilotti S, Shah KV. Human papillomavirus associated with early vulval neoplasia investigated by in situ hybridization. Am J Surg Pathol 1987;11:430-3.
Daling J, Sherman K. Relationship between human papillomavirus infection and tumors of anogenital sites other than cervix. IARC Sci Publ 1992;119:223-41.
Engelman D, Andrade L, Vassallo J. Human papillomavirus infection and p53 protein expression in vulval intraepithelial neoplasia and invasive squamous cell carcinoma. Braz J Med Biol Res 2003;36:1159-65.
Giaquinto C, Del Mistro A, De Rossi A, et al. Vulvar carcinoma in a 12 year-old girl with vertically acquired human immunodeficiency virus infection. Pediatrics 2000;106:57-59.
Pickel H. Early estromal invasion of the vulva. Eur J Gynecol Oncol 1898;10:97-99.
Simpson H. New treatments for vulval intraepithelial neoplasia. Medical Library 2004;2530:4391-455.
Collins C, Hansen L. A clinical stain for use in selecting biopsy sites in patients with vulvar disease. Obstet Gynecol 1966;28:158.
Bornstein J, Kaufmann RH, Adam E, Adler Storthz K. Multicentric intraepithelial neoplasia involving the vulva. Cancer 1988;62:1601-4.
Wright VC, Davies E. Laser surgery for vulvar intraepithelial neoplasia. Principles and results. Am J Obstet Gynecol 1987;156:374.
Millar BE. Vulvar intraepithelial neoplasia treated with cavitational ultrasonic surgical aspiration. Gynecol Oncol 2002;85:114-8.
Wendling J, Saiag P, Berville S, et al. Treatment of undifferentiated vulvar intraepithelial neoplasia with 5% imiquimod cream. Arch Dermatol 2004;140:1220-4.
Benedett JL, Wilson PS, Matissic JP. Epidermal thickness measurements in vulvar intraepithelial neoplasia: a basis for optimal CO2 laser vaporization. J Reprod Med 1992;37:809-12.
Madrigal de la Campa MA, Ruíz Moreno JA. Tratamiento de condilomas acuminados gigantes combinando láser CO2 y electrocirugía. Ginecol Obstet Mex 2000;68(1):27-30.
Gissmann L. Papillomaviruses. Intervirology 1994;37:137.
Lorincz AT. Detection of human papillomavirus DNA without amplification: prospects for clinical utility. IARC Sci Publ 1992;119:135.