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Vulvar pathology

Carol Emi Bretschneider, Sarah M Share, Marie Fidela R Paraiso
BACKGROUND: Severe labial agglutination can be refractory to outpatient management and can lead to voiding dysfunction in postmenopausal women. Labial agglutination is often a sequela of long-standing inflammatory processes, which include untreated lichen planus, lichen sclerosus, and atrophic vaginitis. CASE: An 82-year-old parous woman presented with severe labial agglutination and complete obstruction of her vaginal introitus, causing obstructive voiding symptoms...
February 27, 2018: Female Pelvic Medicine & Reconstructive Surgery
Setareh Akhavan, Jila Agah, Fatemeh Nili
A G2L2 33-year-old woman presented to our clinic with large verrucous warty masses in labia major, perinea and the end portion of her spine measuring about 15 × 7, 9 × 7 and 8 × 8 cm, which had been enlarged following puberty and pregnancy. Her right upper and left lower limbs had gross congenital lymphedema. The masses were removed by superficial partial vulvectomy with a qualified margin and repaired without skin graft. Pathology report showed lymphangioma circumscriptum. Several months of follow up revealed normal healing and no recurrence...
February 27, 2018: Journal of Obstetrics and Gynaecology Research
Georgia Karpathiou, Michel Peoc'h
P16 immunohistochemical expression, a surrogate marker of the retinoblastoma pathway, has become a major adjunct in the routine practice mostly of cervical and head/neck pathology, but with other indications too. In this chapter, a detailed immunohistochemical technique for the detection of p16 is described, followed by indications and interpretation of its expression in uterine, ovarian, vulvar, penile, head-and-neck, melanocytic, and other pathologies.
2018: Methods in Molecular Biology
Tzu-Yin Tang, Tao-Yeuan Wang
OBJECTIVE: To demonstrate a case with a vulvar metastasis masquerading a primary vulvar malignancy. The clinical and histological features, mechanism, and impact to the prognosis are discussed. CASE REPORT: A 58-year-old woman presented to gynecologist for abnormal vaginal discharge. A vulvar nodule was noticed during physical examination. Biopsy showed adenocarcinoma (ADC) and she was referred for further survey under the impression of Bartholin duct ADC. Later she was further found to also have a colorectal tumor with liver metastasis and subsequently received surgery under the suspicion of a double primary cancer involving the colon and vulva...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
M L Yap, G Allo, J Cuartero, M Pintilie, S Kamel-Reid, J Murphy, H Mackay, B Clarke, A Fyles, M Milosevic
AIMS: Human papilloma virus (HPV) has been identified as an aetiological agent in a subset of patients with vulvar squamous cell carcinoma (VSCC). The prognostic role of HPV status in VSCC patients treated with radiotherapy has not yet been determined. We investigated the associations between HPV, p16 and clinical outcome in these women. MATERIALS AND METHODS: Patients undergoing potentially curative radiation treatment for VSCC at a single institution from 2000 to 2009 were retrospectively identified...
February 12, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
Aalia Sachedina, Kiri Chan, Duncan MacGregor, Martin Campbell, Sonia R Grover
STUDY OBJECTIVE: To review our local experience with urogenital RMS to determine the most common clinical presentation(s). DESIGN: Retrospective case series of all cases of female urogenital RMS presenting to a tertiary pediatric hospital between 1996 and 2016. All institutional electronic pathology reports were screened for RMS and those that were pelvic in origin and occurring in female patients were included for further analysis. Seventeen cases of urogenital RMS in female patients were identified and reviewed...
February 5, 2018: Journal of Pediatric and Adolescent Gynecology
Swarupa Mitra, Manoj Kumar Sharma, Inderjeet Kaur, Ruparna Khurana, Kanika Batra Modi, Raman Narang, Avik Mandal, Soumya Dutta
Vulvar carcinoma is a rare and aggressive gynecological malignancy. It affects elderly females, with the mean age at diagnosis being 55-60 years. Regional metastasis to inguinal lymph nodes is common. There is a high incidence of pelvic node involvement, especially in those with pathologically positive inguinal nodes. Surgery appears to be the only curative treatment option in the early stages of the disease. But in most patients, surgery is associated with considerable morbidities and psychosexual issues. Hence, in the quest for a less morbid form of treatment, multimodality approaches with various combinations of surgery, chemotherapy, and radiation therapy have been suggested for advanced vulvar cancers...
2018: Cancer Management and Research
Macit Arvas, Ilker Kahramanoglu, Tugan Bese, Hasan Turan, Isik Sozen, Sennur Ilvan, Fuat Demirkiran
OBJECTIVE: The aim of this study was to determine the impact of clear surgical margin distance and other factors associated with the recurrence and survival of patients with squamous cell carcinoma of the vulva. METHODS/MATERIALS: A total of 107 patients operated for vulvar carcinoma from 1996 to 2016 were included in the analysis. Patients were divided into subgroups with clear pathological margin of 2 mm or less, greater than 2 to less than 8 mm, and 8 mm or greater for the analysis of the prognostic impact of the clear margin distance...
January 10, 2018: International Journal of Gynecological Cancer
S G Gavrilov, M D Temirbolatov
The article is a literature review presenting modern data on applied anatomy of the pelvic veins, diagnosis and treatment of pelvic varicose veins, pelviperineal reflux and vulvar varicosity, lower limb varicose veins, which were caused by pathological reflux from varicose pelvic veins. Presented is the information on tactical approaches in treatment of combined varicose veins of the pelvis and lower limbs, surgical decision-making for correction of pelviperineal reflux, methods of operative and phlebosclerosing interventions on pelvic and superficial veins of the perineum and lower limbs...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Takashi Ichiyama, Daisuke Gomi, Toshirou Fukushima, Takashi Kobayashi, Nodoka Sekiguchi, Akiyuki Sakamoto, Shigeru Sasaki, Keiko Mamiya, Tomonobu Koizumi, Yoshihisa Hama
A 58-year-old woman with a histologically confirmed diagnosis of vulvar extramammary Paget's disease (EMPD) was referred to our hospital due to locally advanced and relapsed EMPD. The patient had undergone surgical resection three times for relapsed vulvar EMPD over a period of 12 years, but developed locally advanced and unresectable EMPD. As pathological examination indicated that the lesion was positive for human epidermal growth factor receptor 2 (HER2) on immunohistochemical staining, the patient was treated with trastuzumab plus paclitaxel...
November 2017: Molecular and Clinical Oncology
Nienke C Te Grootenhuis, Anne-Floor W Pouwer, Geertruida H de Bock, Harry Hollema, Johan Bulten, Ate G J van der Zee, Joanne A de Hullu, Maaike H M Oonk
BACKGROUND: In patients treated for early-stage squamous cell vulvar carcinoma local recurrence is reported in up to 40% after ten years. Knowledge on prognostic factors related to local recurrences should be helpful to select high risk patients and/or to develop strategies to prevent local recurrences. OBJECTIVE: This systematic review aims to evaluate the current knowledge on the incidence of local recurrences in vulvar carcinoma related to clinicopathologic and cell biologic variables...
March 2018: Gynecologic Oncology
W Satmary, C H Holschneider, L L Brunette, S Natarajan
OBJECTIVE: We studied a large population of women with high-grade vulvar intraepithelial neoplasia (VIN) in order to identify patient and treatment-related risk factors for recurrence and progression to cancer. METHODS: For this retrospective cohort study of women with a histologic diagnosis of VIN within Southern California Permanente Medical Group between 1995 and 2007 medical records were reviewed; clinical, demographic and pathologic data were collected. Statistical analyses included Chi-squared and Student's t-tests, univariate and multivariate logistic regression, and cumulative incidence analysis...
January 2018: Gynecologic Oncology
Valeria M Moncayo, Adina L Alazraki, Naomi P Alazraki, John N Aarsvold
Accurate staging of many cancers with no clinical evidence of lymph node involvement is often a critical component of the management of such cancers and is generally and historically accomplished by accurate pathological assessment of multiple nodes. Unfortunately, such assessment usually involves excision of the multiple nodes and can result in significant morbidities. Over the past half century, and particularly over the last quarter century, investigators have defined and refined the "sentinel lymph node(s)" concept and have developed and investigated sentinel lymph node biopsy (SLNB) procedures...
November 2017: Seminars in Nuclear Medicine
Ge Shi, Wei Li, Ni Liang, Ting-Ting Wang, Ying Zhou, Yi-Ming Fan
Winer's dilated pore is an infrequent appendageal tumor characterized by a giant comedone on the face, neck, and upper trunk in adults. We report a 57-year-old woman who developed multiple asymptomatic black papules on both labia majora. Histopathology showed grouped dilated follicles lined by keratinizing squamous epithelium in the superficial dermis. The superficial lining epithelium and interfollicular epidermis were atrophic, while the deep epithelium showed mild proliferation and melanin pigmentation with a few short projections extending into the surrounding dermis...
July 2017: Anais Brasileiros de Dermatologia
Debra S Heller
OBJECTIVES: Pathologist-clinician communication has been an ongoing topic in the literature. Pathology reports are geared to assisting clinicians with patient therapy, but sometimes there are barriers to communication. This survey aims to explore clinicians' understanding of their pathology reports in the membership of the International Society for Vulvovaginal Disease (ISSVD). METHODS: An email survey was sent to all members of the ISSVD. RESULTS: Surveys were emailed to 397 members, with 91 responding (23 %)...
October 2017: Journal of Lower Genital Tract Disease
Beverly Long, Adam R Schmitt, Amy L Weaver, Michaela McGree, Jamie N Bakkum-Gamez, Jerry Brewer, William A Cliby
OBJECTIVES: To determine surgical and pathologic variables associated with recurrence in extramammary Paget's disease (EMPD). METHODS: Medical records of patients seeking care for EMPD from 1/1992-9/2015 were reviewed. Follow-up was restricted to 5years following primary surgery. Recurrence-free survival (RFS) was estimated using the Kaplan-Meier method. Risk factors were evaluated for an association with recurrence and positive margins, respectively, using Cox proportional hazards regression and logistic regression...
November 2017: Gynecologic Oncology
Xue Xiao, Yi-Bo Meng, Peng Bai, Juan Zou, Ya Zhang, Tri M Bui Nguyen, Jian-Guo Xiao, Xue-Mei Gao, Bang-Fen Wen
Objective: Describe for the first time the clinical, epidemiological features of vulvar cancer in southwest China. Identify risk factors and provide reference for the prevention of vulvar cancer. Method: We retrospectively analyzed 885 patients admitted to the West China Second University Hospital for vulvar diseases between 2006 and 2016. Vulvar cancer patients with previously diagnosed vulvar nonneoplastic epithelial disorders (n=132) were analyzed and compared to those without prior history of vulvar nonneoplastic epithelial disorders (n=219)...
2017: Journal of Cancer
A Karim Ahmed, C Rory Goodwin, Nancy Abu-Bonsrah, Doreen Nguyen, Daniel M Sciubba
Extramammary Paget disease is an intraepithelial neoplasm affecting cells rich in apocrine glands-often located in the vulvar, scrotal, or perianal region. It typically affects older patients, between the ages of 50 and 80years old, and is most often limited to the epidermis. A 47-year-old Asian male first presented with enlargement of the right inguinal lymph node. A subsequent biopsy revealed extrammamary Paget disease of the scrotum. The patient eventually developed significant worsening back pain with bilateral lower extremity numbness and weakness three months later...
November 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Warner K Huh, Elmar A Joura, Anna R Giuliano, Ole-Erik Iversen, Rosires Pereira de Andrade, Kevin A Ault, Deborah Bartholomew, Ramon M Cestero, Edison N Fedrizzi, Angelica L Hirschberg, Marie-Hélène Mayrand, Angela Maria Ruiz-Sternberg, Jack T Stapleton, Dorothy J Wiley, Alex Ferenczy, Robert Kurman, Brigitte M Ronnett, Mark H Stoler, Jack Cuzick, Suzanne M Garland, Susanne K Kjaer, Oliver M Bautista, Richard Haupt, Erin Moeller, Michael Ritter, Christine C Roberts, Christine Shields, Alain Luxembourg
BACKGROUND: Primary analyses of a study in young women aged 16-26 years showed efficacy of the nine-valent human papillomavirus (9vHPV; HPV 6, 11, 16, 18, 31, 33, 45, 52, and 58) vaccine against infections and disease related to HPV 31, 33, 45, 52, and 58, and non-inferior HPV 6, 11, 16, and 18 antibody responses when compared with quadrivalent HPV (qHPV; HPV 6, 11, 16, and 18) vaccine. We aimed to report efficacy of the 9vHPV vaccine for up to 6 years following first administration and antibody responses over 5 years...
November 11, 2017: Lancet
Jasleen K Grewal, Peter Eirew, Martin Jones, Kenrry Chiu, Basile Tessier-Cloutier, Anthony N Karnezis, Aly Karsan, Andy Mungall, Chen Zhou, Stephen Yip, Anna V Tinker, Janessa Laskin, Marco Marra, Steven J M Jones
Whole-genome and transcriptome sequencing were performed to identify potential therapeutic strategies in the absence of viable treatment options for a patient initially diagnosed with vulvar adenocarcinoma. Genomic events were prioritized by comparison against variant distributions in the TCGA pan-cancer data set and complemented with detailed transcriptome sequencing and copy-number analysis. These findings were considered against published scientific literature in order to evaluate the functional effects of potentially relevant genomic events...
November 2017: Cold Spring Harbor Molecular Case Studies
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