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Vulvar diseases

Yuzo Nagai, Sinsuke Kazama, Daisuke Yamada, Takuya Miyagawa, Koji Murono, Koji Yasuda, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Kazushige Kawai, Yuri Masui, Hiroaki Nozawa, Hironori Yamaguchi, Soichiro Ishihara, Takafumi Kadono, Toshiaki Watanabe
Treatment of perianal and vulvar extramammary Paget disease (EMPD), rare intraepithelial malignancies, is often challenging because of its potential to spread into the anal canal. However, there is still no consensus regarding the optimal resection margin within the anal canal. Between 2004 and 2014, six patients (three with perianal EMPD and three with vulvar EMPD) in which the spread of Paget cells into the anal canal was highly suspected were referred to our department. To evaluate the disease extent within the anal canal, preoperative mapping biopsy of the anal canal was performed in five out of six patients...
October 2016: Annals of Dermatology
Sara Iacoponi, Ignacio Zapardiel
AIMS: Vulvar cancer is a rare disease. In western European countries, the incidence is 1.2 cases per 100,000 women/year. The aim of this study was to analyze the management and disease-free survival (DFS) of vulvar cancer among European countries. METHODS: An international multicenter retrospective study including patients diagnosed of squamous cell vulvar cancer was performed. Countries analyzed included Austria, Germany, Greece, Italy, Latvia, Lithuania, Poland, Portugal, Spain and Turkey...
October 14, 2016: Gynecologic and Obstetric Investigation
Vicki B Benard, Philip E Castle, Steven A Jenison, William C Hunt, Jane J Kim, Jack Cuzick, Ji-Hyun Lee, Ruofei Du, Michael Robertson, Scott Norville, Cosette M Wheeler
Importance: A substantial effect of human papillomavirus (HPV) vaccines on reducing HPV-related cervical disease is essential before modifying clinical practice guidelines in partially vaccinated populations. Objective: To determine the population-based cervical intraepithelial neoplasia (CIN) trends when adjusting for changes in cervical screening practices that overlapped with HPV vaccination implementation. Design, Setting, and Participants: The New Mexico HPV Pap Registry, which captures population-based estimates of both cervical screening prevalence and CIN, was used to compute CIN trends from January 1, 2007, to December 31, 2014...
September 29, 2016: JAMA Oncology
X Lévy
Endoscopy enables a rapid and non-traumatic examination of the vaginal cavity of female dogs. Its implementation requires specific equipment as well as knowledge about the species-specific vaginal anatomy and the procedure. Vaginoscopy is the diagnostic tool of choice for several vaginal conditions and diseases such as congenital abnormalities, neoplasia or ectopic ureter. Furthermore, vaginal inspection may provide additional information in cases of vulvar discharge or infertility. Vaginoscopy is a superior tool compared to other methods in assisted reproduction...
September 2016: Reproduction in Domestic Animals, Zuchthygiene
Jorge Daniel Oldan, Parth S Patel
IMPORTANCE: Positron emission tomography/Computed tomography(PET/CT) is widely used for gynecologic cancers. OBJECTIVE: To determine when PET/CT should be used for gynecologic cancers. EVIDENCE ACQUISITION: PubMed was reviewed for articles on PET/CT of all gynecologic cancers. National Comprehensive Cancer Network, Society of Gynecologic Oncology, and American College of Radiology guidelines were reviewed. RESULTS: Whole-body PET/CT is useful for (1) initial staging of cervical and endometrial cancer, posttherapy assessment, radiation therapy planning, and posttreatment surveillance of cervical cancer, and (2) assessment of recurrence of cervical, endometrial, or ovarian cancer in the presence of symptoms...
September 2016: Obstetrical & Gynecological Survey
L S Nooij, F A M Brand, K N Gaarenstroom, C L Creutzberg, J A de Hullu, M I E van Poelgeest
Recurrent disease occurs in 12-37% of patients with vulvar squamous cell carcinoma (VSCC). Decisions about treatment of recurrent VSCC mainly depend on the location of the recurrence and previous treatment, resulting in individualized and consensus-based approaches. Most recurrences (40-80%) occur within 2 years after initial treatment. Currently, wide local excision is the treatment of choice for local recurrences. Isolated local recurrence of VSCC has a good prognosis, with reported 5-year survival rates of up to 60%...
October 2016: Critical Reviews in Oncology/hematology
Diogo Morbeck, Aline Caldart Tregnago, Glauco Baiocchi Netto, Carlos Sacomani, Patricia Maria Peresi, Cynthia Toledo Osório, Luciana Schutz, Stephania Martins Bezerra, Louise de Brot, Isabela Werneck Cunha
AIMS: GATA3 has been reported as a specific urothelial marker among organs in the pelvic region and has been classified as highly sensitive and specific for urothelial and breast carcinomas. Our aim was to verify GATA3 expression in extramammary Paget disease (EMPD) and check if it can be use to differentiate primary vulvar Paget disease (PVPD) from pagetoid urothelial intraepithelial neoplasia (PUIN). Also we analyzed Her2 protein expression and HER2 gene amplification and its role as prognostic factors in EMPD METHODS AND RESULTS: We analyzed GATA3 and Her2 expression in 11 primary vulvar Paget disease and also 2 PUIN cases...
September 16, 2016: Histopathology
Gozde Kulhan, Mehmet Kulhan, Umit Nayki, Cenk Nayki, Pasa Ulug, Emrah Akkaya, Onur S Aldemir, Yusuf Yildirim, Mehmet Sipahi
OBJECTIVES: Our study aimed to determine the epidemiological characteristics and diagnostic and treatment protocols of primary vaginal carcinoma. Also, we compared the clinical and pathological features of primary vaginal carcinoma which intersect with cervical and vulvar carcinomas. MATERIAL AND METHODS: Sixteen patients with primary vaginal carcinoma, admitted to the Department of Gynecologic Oncology, Izmir Tepecik Training and Research Hospital between January 1983 and December 2012, were evaluated retrospectively...
2016: Ginekologia Polska
Sarah Leonard, Merlin Pereira, Richard Fox, Naheema Gordon, Jason Yap, Sean Kehoe, David Luesley, Ciaran Woodman, Raji Ganesan
OBJECTIVE: Cancer initiation and progression has been linked to aberrant expression of the DNA methyltransferases (DNMT), the enzymes which establish and maintain DNA methylation patterns throughout the genome. In this study, we investigated if DNMT expression in vulvar squamous cell carcinomas (VSCC) was related to clinical outcome. METHODS: DNMT1, DNMT3A and DNMT3B expression was measured in a subset of cases drawn from a cohort of consecutive women treated for primary VSCC at the Pan Birmingham Gynaecological Cancer Centre between 2001 and 2008...
September 9, 2016: Gynecologic Oncology
Carol L Kuhle, Ekta Kapoor, Richa Sood, Jacqueline M Thielen, Aminah Jatoi, Stephanie S Faubion
Decision making regarding the use of menopausal hormone therapy (MHT) for the treatment of bothersome menopausal symptoms in a cancer survivor can be complex, and includes assessment of its impact on disease-free or overall survival. Estrogen receptors are present in several cancer types, but this does not always result in estrogen-mediated tumor proliferation and adverse cancer-related outcomes. Estrogen may even be protective against certain cancers. Menopausal hormone therapy is associated with an increased risk of recurrence and mortality after diagnosis of some cancer types, but not others...
October 2016: Maturitas
Tae-Hee Kim, Bel Seap, Soo Ah Kim, Gyeong-Eun Heo
Infections of the vulva can present a complex differential to the gynecologist, ranging from superficial skin infections to lifethreatening necrotizing fasciitis. Recognition and timely treatment remain universal to skin and soft-tissue infections as the subcutaneous anatomy of the vulva can facilitate rapid spread to other tissues with significant morbidity and mortality. Employing a multidisciplinary team approach to care for vulvar cellulitis and abscess can guide treatment from antibiotic therapies to more aggressive surgical debridement...
August 2016: Journal of Menopausal Medicine
Pedro Martinez-Castro, Andrés Poveda, José Luis Guinot, Lucas Minig
Vulvar cancer is a rare disease affecting elderly women that is commonly treated with surgery, radiation, and chemotherapy. When tumors compromise the urethra and the anus, or when it is in the groin lymph nodes, radiotherapy, chemotherapy, or both are necessary after surgery.The treatment of locally advanced vulvar cancer has suffered significant changes though the recent decades. So far, the best sequence of treatment is not known: surgery, chemotherapy, or radiotherapy. The radical surgeries usually need a long recovery term both in the region of the vulva and in the area of the groin lymph nodes...
August 29, 2016: International Journal of Gynecological Cancer
Divya Natesan, Matthew Susko, Laura Havrilesky, Junzo Chino
OBJECTIVES: This study aimed to evaluate clinical outcomes after chemoradiation (CRT) for the definitive (nonsurgical) treatment of vulvar cancer. MATERIALS AND METHODS: Women with vulvar cancer treated with definitive CRT at a single academic institution between 1994 and 2015 were retrospectively identified. Overall survival (OS), freedom from local recurrence, freedom from distant recurrence, and late toxicities were estimated using the Kaplan-Meier method at 3 years after radiotherapy completion...
August 29, 2016: International Journal of Gynecological Cancer
Chieko Sakae, Ken Yamaguchi, Noriomi Matsumura, Hidekatsu Nakai, Yumiko Yoshioka, Eiji Kondoh, Junzo Hamanishi, Kaoru Abiko, Masafumi Koshiyama, Tsukasa Baba, Aki Kido, Masaki Mandai, Ikuo Konishi
OBJECTIVE: To identify suitable diagnostic tools and evaluate the efficacy of sentinel lymph node (SLN) biopsy for inguinal lymph node metastasis in vulvar cancer. METHODS: Data from 41 patients with vulvar cancer were evaluated retrospectively, including magnetic resonance imaging (MRI) measurements, SLN biopsy status, groin lymph node metastasis, and prognosis. RESULTS: SLN biopsy was conducted in 12 patients who had stage I to III disease...
June 29, 2016: Journal of Gynecologic Oncology
Megan L Falsetta, David C Foster, Collynn F Woeller, Stephen J Pollock, Adrienne D Bonham, Constantine G Haidaris, Richard P Phipps
: Chronic vulvar pain is alarmingly common in women of reproductive age and is often accompanied by psychological distress, sexual dysfunction, and a significant reduction in quality of life. Localized provoked vulvodynia (LPV) is associated with intense vulvar pain concentrated in the vulvar vestibule (area surrounding vaginal opening). To date, the origins of vulvodynia are poorly understood, and treatment for LPV manages pain symptoms, but does not resolve the root causes of disease...
August 17, 2016: Journal of Pain: Official Journal of the American Pain Society
Suzanne M Garland, Jorma Paavonen, Unnop Jaisamrarn, Paulo Naud, Jorge Salmerón, Song-Nan Chow, Dan Apter, Xavier Castellsagué, Júlio C Teixeira, S Rachel Skinner, James Hedrick, Genara Limson, Tino F Schwarz, Willy A J Poppe, F Xavier Bosch, Newton S de Carvalho, Maria Julieta V Germar, Klaus Peters, M Rowena Del Rosario-Raymundo, Grégory Catteau, Dominique Descamps, Frank Struyf, Matti Lehtinen, Gary Dubin
We evaluated the efficacy of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine in preventing HPV-related disease after surgery for cervical lesions in a post-hoc analysis of the PApilloma TRIal against Cancer In young Adults (PATRICIA; NCT00122681). Healthy women aged 15-25 years were randomized (1:1) to receive vaccine or control at months 0, 1 and 6 and followed for 4 years. Women were enrolled regardless of their baseline HPV DNA status, HPV-16/18 serostatus, or cytology, but excluded if they had previous or planned colposcopy...
December 15, 2016: International Journal of Cancer. Journal International du Cancer
Ch Tsvetkov, G Gorchev, S Tomov, M Nikolova, G Genchev
AIM: The aim of the research was to evaluate and analyse prognosis and prognostic factors in patients with squamous cell vulvar carcinoma after primary surgery with individual approach applied during the course of treatment. MATERIALS AND METHODS: In the period between January 2000 and July 2010, 113 patients with squamous cell carcinoma of the vulva were diagnosed and operated on at Gynecologic Oncology Clinic of Medical University, Pleven. All the patients were monitored at the same clinic...
2016: Akusherstvo i Ginekologii︠a︡
Theresa A Lawrie, Andrew Nordin, Manas Chakrabarti
Clinical Question: Which interventions are the most effective and tolerable for treating usual-type vulvar intraepithelial neoplasia? Bottom Line: Provided cancer is not suspected, usual-type vulvar intraepithelial neoplasia treatment, including medical and surgical options, can be individualized to take into account the site, extent of disease, and a woman's preferences, with a commitment to long-term follow-up.
August 4, 2016: JAMA Oncology
Nayi Zongo, Nina Korsaga-Somé, Amandine Banata Gang-Ny, Edgar Ouangré, Maurice Zida, Aimé Sosthène Ouédraogo, Aboubacar Hirrhum Bambara, Augustin Tozoula Bambara, Si Simon Traore, Pascal Niamba, Adama Traoré, Ahmadou Dem
BACKGROUND: Vulvar cancer is a rare gynaecological cancer. In Burkina Faso, the diagnosis of vulvar cancers is delayed and the prognosis is poor. However, no specific study on vulvar cancers has been conducted at the moment. This work aimed to study the characteristics of these cancers. METHODS: This is a prospective study on histologically confirmed primary cancers of the vulva diagnosed between 1st January 2013 and 30th June 2015. The demographic and clinical aspects were studied at the Yalgado Ouedraogo University Hospital of Ouagadougou (CHU-YO)...
2016: Infectious Agents and Cancer
Katherine LePage, Amanda Selk
INTRODUCTION: Vulvodynia is a chronic pain disorder that negatively impacts the quality of life of affected women. AIM: The goal of this study was to identify unmet needs among localized provoked vulvodynia patients. METHODS: A qualitative needs assessment was performed in a subspecialized vulvar clinic in a single academic institution in Canada. Semistructured interviews were conducted, recorded, and analyzed using the constant comparative method of grounded theory to identify common themes...
July 30, 2016: Sexual Medicine
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