Introduction: Invasive cancers of the vulva are uncommon;it is a pathology of the elderly. More and more young women are concerned. Objectives: To study and analyze vulvar cancer in our context. Patients and Method: R...Introduction: Invasive cancers of the vulva are uncommon;it is a pathology of the elderly. More and more young women are concerned. Objectives: To study and analyze vulvar cancer in our context. Patients and Method: Retrospective, descriptive and analytical study carried out in the Gynecology Department of the Owendo University Hospital over a period of 5 years from 2020 to 2024. All cancer cases of the period were concerned and we included vulvar cancers. We studied the epidemiological, clinical and therapeutic aspects. Results: We collected 5 files, the median age was 41.8 years [30 - 57 years], the average consultation time was 18 months [12 - 36 months]. Ulcerated, budding, and itchy lesions were present in 80% of cases. Invasive squamous cell carcinoma was the histological type present in all patients. Surgery was performed in 40% of cases. Concomitant radiochemotherapy (CRC) was offered in all patients. HIV was the comorbidity found in 100% of cases. Conclusion: Vulvar cancers are rare. They are often seen at advanced stages because of their location, the taboo nature they represent on the one hand and underdiagnosis on the other.展开更多
OBJECTIVE: To clarify the role of midkine (MK) in vulvar carcinogenesis though examination of its expression in vulvar lesions including vulvar condyloma acuminata (VCA), vulvar intraepithelial neoplasia (VIN) and vul...OBJECTIVE: To clarify the role of midkine (MK) in vulvar carcinogenesis though examination of its expression in vulvar lesions including vulvar condyloma acuminata (VCA), vulvar intraepithelial neoplasia (VIN) and vulvar squamous cell carcinomas (VSCC), and to analyze the relationship between MK expression and human papilloma virus (HPV) infection. METHODS: Thirty VSCC, 15 VIN and 10 VCA patients were studied by streptavidin-biotin-immunoperoxidase method. MK expression was compared with clinicopathologic features of vulvar tumors. RESULTS: MK was expressed in 26 of 30 VSCC (87%), 3 of 5 VIN III and all VCA samples, whereas no MK expression was detected in the VIN I-II samples or in normal epithelium. The difference of MK expression between VIN III and VSCC was statistically significant (P展开更多
In the present paper,444 patients with vulvar leukoplasia were treated by selectingacupoints in the local area and along the meridian plus Qugu（CV 2）and Huiyin（CV 1）and usingelectro-thermal needling.The total effe...In the present paper,444 patients with vulvar leukoplasia were treated by selectingacupoints in the local area and along the meridian plus Qugu（CV 2）and Huiyin（CV 1）and usingelectro-thermal needling.The total effective rate was up to 100.0％and the cure rate 87.3％.Theelectro-thermal effect directly acted on the affected area but strengthened the immunologic function ofthe whole body and raised the content of serum copper.展开更多
Background:One of the biggest challenges in the swine industry is to increase female reproductive efficiency.Recently,vulva score categories(VSC),assessed prior to puberty,has been proposed as an indicator trait of ef...Background:One of the biggest challenges in the swine industry is to increase female reproductive efficiency.Recently,vulva score categories(VSC),assessed prior to puberty,has been proposed as an indicator trait of efficient reproductive performance in sows.The objective of this study was to validate the use of VSC as an indicator trait for reproductive performance,and to perform genetic and genomic analyses for VSC.Methods:The phenotypic relationship of VSC,using a three-point scale:small(VSC-S),medium(VSC-M),and large(VSC-L),on reproductive performance was evaluated on three farms.VSC was measured at 15 weeks of age,for farms 1 and 2,and at 14 weeks of age for farm 3 on 3981 Yorkshire gilts,in which 1083 had genotypes(~50 K SNPs).Genetic parameters for VSC with reproductive traits were estimated using ssGBLUP.A Genome-wide association study(GWAS)for VSC was performed using BayesB.Results:For the phenotypic analysis of VSC across datasets,differences in performance were identified there was a significant effect(P≤0.05)for the interaction between Farm and VSC for total number dead(TND),and a trend(P<0.10)for total number born(TNB).There were significant(P≤0.05)pre-defined contrasts of VSC-S versus VSC-M+L on TNB,number born alive(NBA),TND,number of stillborn(NSB),and number of mummies(MUM).Heritability estimates for VSC as a categorical trait(VSCc)and a quantitative trait(VSCq)were 0.40±0.02 and 0.83±0.02,respectively,for across farm,0.13±0.07 and 0.20±0.10,respectively,for Farm1,0.07±0.07 and 0.09±0.09,respectively,for Farm2,and 0.20±0.03 and 0.34±0.05,respectively,for Farm3.For across farms,favorable genetic correlations estimates were found for TNB(0.28±0.19)and NBA(0.26±0.17).Within farms,moderate genetic correlations between VSC with reproductive traits were found for TNB(0.61±0.47)and MUM(0.69±0.47)for farm 1,for number of services until first farrow(NS;0.69±0.38)and unique service with successful first farrow(SFS;−0.71±0.38)for farm 3.Multiple genomic regions associated with VSCc were identified.Of these,a QTL located on chromosome 3 at 33–34Mb accounted for about 7.1%of the genetic variance for VSCc and VSCq.This region harbors the gene PRM1 that has been associated with early embryonic development in pigs.Conclusions:The results support potential of VSC for improved reproductive efficiency on first-parity performance,but the results might depend on the interaction between environmental factors and VSC,as well as potentially additive genetics.展开更多
An ovarian malignant melanoma sometimes occurs from ovarian teratoma. Ovarian metastatic malignant melanoma is extremely rare. We describe a patient in whom vulvar melanoma (previously resected) metastasized to the ov...An ovarian malignant melanoma sometimes occurs from ovarian teratoma. Ovarian metastatic malignant melanoma is extremely rare. We describe a patient in whom vulvar melanoma (previously resected) metastasized to the ovary, making ovarian metastatic malignant melanoma. A 43-year-old Japanese woman was referred to us because of left ovarian tumor. She had undergone resection for malignant melanoma on the right labia minora with inguinal lymph node metastasis (pT1bN1aM0, stage IIIA, FIGO 2008). Eighteen months after this surgery, CT scans revealed left ovarian tumor and swelled pelvic lymph nodes, with a pelvic examination disclosing a left adnexal solid mass, with normal serum CA125 level (21.7 U/mL). Laparotomy revealed a left solid ovarian tumor measuring 4 cm, which was covered with a smooth grayish capsule. The right ovary, uterus, and pelvic cavity appeared normal. Upon sectioning during the surgery, the cross-sectional surface of the left ovary revealed a dark brown solid tumor. Following an intra-operative frozen-section diagnosis as metastatic melanoma, total hysterectomy with bilateral salpingo-oophorectomy and pelvic lymph dissection was performed. Histological examination confirmed the diagnosis as malignant melanoma metastasis to the left ovary and the obturator lymph node: the same laterality (left) as the primary site. The tumor was entirely composed of malignant melanoma cells with no evidence of teratoma. Combined chemotherapy with dabrafenib mesylate and trametinib was planned based on the positive BRAF mutations. This case highlights the importance that physicians should have high index of suspicion for the occurrence of ovarian melanoma metastasis after melanoma surgery. We also made extensive literature review on this issue, of which description may contribute to better understanding of this condition.展开更多
Vulvar cancer is an uncommon tumor and represents 3%-5% of all female genital tract malignancies. Squamous cell carcinoma (SCC) is the most common carcinoma of the vulva. Distant metastasis of recurrent vulvar squamou...Vulvar cancer is an uncommon tumor and represents 3%-5% of all female genital tract malignancies. Squamous cell carcinoma (SCC) is the most common carcinoma of the vulva. Distant metastasis of recurrent vulvar squamous cell carcinoma is rare and occurs late in the disease process. We report the first case of kidney metastasis from a vulvar squamous cell carcinoma in a 68-year-old Caucasian female. On initial presentation she was treated with radical vulvectomy, upper urethrectomy with bilateral inguinal and deep femoral lymph node dissection. She was staged as FIGO stage IVA and also received adjuvant chemo-radiation. She remained in remission for 24 months. Subsequently she was found to have a kidney tumor and underwent nephrectomy and was diagnosed with metastatic squamous cell carcinoma from the vulva to the kidney. In cases of recurrent vulvar carcinoma distant metastasis to the bones, breast, and brain is only rarely reported. Metastasis to kidneys from vulvar carcinoma is exceptionally rare with no reported cases in the literature. Renal metastasis should be considered in the differential diagnosis of kidney tumor in this group of women.展开更多
Objective: To review our experience in diagnosis, pathology, treatment, and prognosis of extramammary Paget's disease of the vulva. Methods: Seven patients with vulvar Paget's disease who were treated at the C...Objective: To review our experience in diagnosis, pathology, treatment, and prognosis of extramammary Paget's disease of the vulva. Methods: Seven patients with vulvar Paget's disease who were treated at the Cancer Hospital cAMS were retrospectively reviewed for the period from 1960 to 2002. The symptoms, location of disease, pathology, mode of treatment and current status of the patients were evaluated. Results: A total of seven women with Paget抯 disease of the vulva were admitted to the Department of Gynecologic of Oncology. The mean age was 67.3 years (range 54~81 years). Vulvar lesion and pruritus were the common symptoms and it took average 3.4 years to confirm the diagnosis. All patients underwent surgery as initial treatment, vulvectomy was performed for 2 patients and radical vulvectomy plus groin node dissection for 5 patients. Two patients had invasive disease and four were associated with underlying adenocarcinoma. Five patients experienced recurrence, on average, 16.2 months after the surgery. Four of them underwent radiotherapy or chemotherapy and the other received no further treatment. The mean follow-up time was 41.1 months. Three patients, with invasive lesion or underlying adenocarcinoma were dead of the disease. Conclusion: There is a delay in the diagnosis of vulvar Paget's disease. The major treatment is surgery. Recurrence is relatively common. Patients with invasive disease or underlying carcinoma have a poor prognosis.展开更多
Objective： To analyze the clinicopathological features and differential diagnosis of angiomyofibroblastoma （AMFB） of the vulva. Methods： Two cases of AMFB were examined by light microscopy and immunohistochemical ...Objective： To analyze the clinicopathological features and differential diagnosis of angiomyofibroblastoma （AMFB） of the vulva. Methods： Two cases of AMFB were examined by light microscopy and immunohistochemical study and to discuss the clinicopathological features and differential diagnosis of AMFB with the reference to the literature. Results： Tumors were all circumscribed, and 〈5 cm in diameter. Microscopically, the tumors were composed of spindle or polygonal cells that were cellularly or hypocellularly arranged with perivascular accentuation in a mucoid or fibrocollagenous background. The tumors contained numerous small- to medium-sized blood vessels, which were characteristically thin walled. Immunohistochemically, two cases of tumor cells were positive for vimentin, SMA, CD34（＋） and FⅧ（＋）. Desmin and MSA were positive in one case; Cytokeratin, S-100, CD31 were negative in both. Conclusion： AMFB is a rare, benign soft tissue tumor that occurs in the genital tract of adult women. The origin remains unclear, but it is suggested that an origin from a perivascular pluripotent stem cell that is capable of myofibroblastoma differentiation. Angiomyofibroblastoma should be differentiated from other neoplasms of the vulva such as aggressive angiomyxoma, superficial angiomyxoma and cellular angiofibroma.展开更多
Langerhans cell histiocytosis （LCH） of the female genital tract is rare. Only 20 cases of primary vulva LCH have been previously reported in the medical literature. In this report, we describe an additional case of ...Langerhans cell histiocytosis （LCH） of the female genital tract is rare. Only 20 cases of primary vulva LCH have been previously reported in the medical literature. In this report, we describe an additional case of LCH on the vulva. A 28-year-old Chinese woman presented with a two-year history of ulcerous lesions on the left vulva. No associated temperature, tiredness, or general malaise was observed. A diagnosis of LCH had been made by biopsy. Histological and immunohistochemical findings were characteristic of LCH. After two weeks of combined medical therapy, including interferon, prednisone, and methotrexate （MTX）, the lesion started to cicatrize. Now, the patient was well throughout a 18-month follow up, showing no symptoms or signs of local recurrence or systemic spread. The occurrence of LCH on the vulva is very unusual. It is necessary to perform a biopsy on the lesion, rule out the possibility of multiorgan involvement. There are no standard treatment options for this rare disease. The most effective treatment options remain elusive. In our case, combined medical therapy was proved to be effective.展开更多
Object: To determine if vulvar melanosis progressed to melanoma over a period of 20 years or more. Methods: In 2010 the hospital records from the Royal Brisbane Hospital Vulvar Clinic between 1976 and 1988 were review...Object: To determine if vulvar melanosis progressed to melanoma over a period of 20 years or more. Methods: In 2010 the hospital records from the Royal Brisbane Hospital Vulvar Clinic between 1976 and 1988 were reviewed and cross checked with the state wide Queensland Centre for Gynaecological Cancer (QCGC) data base to determine if any patient had been lost to follow up and subsequently developed a vulvar melanoma. Data collected were stored and analysed using the computer software Statistical Package for the Social Sciences (SPSS) 11.0. Results: None of the 12 patients developed vulval melanoma in the years up to 2010. Conclusion: In this small group, followed for more than 20 years, melanosis was not a precursor of melanoma. One patient, who attended the Vulvar Clinic but was not included in this melanosis study, was found to have co-existing melanosis well away from her melanoma in situ and malignant melanoma at presentation. It was not possible to determine if these findings represented a progression of the benign to malignant. Biopsy of abnormal hyper pigmented vulvar skin is recommended. Current knowledge suggests that vulvar melanosis is a benign condition but to be on the safe side follow up of all hyper pigmented vulval lesions to detect early malignant change is recommended.展开更多
Background: Vulva haematoma is an uncommon complication of childbirth that can cause maternal death if not properly managed. We present a case of large vulva haematoma managed conservatively with good outcome in UNTH ...Background: Vulva haematoma is an uncommon complication of childbirth that can cause maternal death if not properly managed. We present a case of large vulva haematoma managed conservatively with good outcome in UNTH Enugu. Clinical Presentation: This was a case of an unbooked 24 years old primiparous woman referred from a private hospital to UNTH, Enugu on account of left-sided vulva swelling of four hours duration following a spontaneous vaginal delivery of a live male baby that weighed 3.6 kilogrammes. She was given episiotomy which was repaired. Vaginal examination showed a swelling involving left labia majora and minora and extending to the perineal region and vagina. It measured 12 cm × 10 cm, firm and mildly tender. She was resuscitated with intravenous fluid, transfused with two units of blood and commenced on antibiotic and analgesic. The vulva haematoma was monitored and it remained the same size for two days, and then progressively regressed. She was discharged home on the 9th day. Conclusion: Conservative management of large vulva haematoma involving good counseling, correction of anaemia, institution of antibiotics, analgesic and close monitoring leads to effective resolution, reduced cost, scarring, pain and dyspareunia.展开更多
<strong>Background:</strong> <span style="font-family:""><span style="font-family:Verdana;">The incidence of cancer vulva is increasing. 50% of cases are occurring at y...<strong>Background:</strong> <span style="font-family:""><span style="font-family:Verdana;">The incidence of cancer vulva is increasing. 50% of cases are occurring at younger age especially the type related to Human Papilloma Virus infection. Cancer vulva can be prevented. Awareness of cancer vulva is deficient among women and healthcare providers. In this study we looked for a correlation between the most significant vulval symptoms to be associated with cancer vulva in order to educate women and to provide guidance for the health care providers. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> 569 women were enrolled in this observational cohort study. The patients were stratified according to their symptoms </span><span style="font-family:Verdana;">into 5 groups. Biopsy from the vulva, unless the lesion is obviously benign.</span> <b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Vulvar lesion, as a symptom (mass-ulcer), was significantly associat</span><span style="font-family:Verdana;">ed with detection of vulvar cancer (</span><i><span style="font-family:Verdana;">P</span></i><span> </span></span><span style="font-family:""><span style="font-family:Verdana;">≤ </span><span><span style="font-family:Verdana;">0.001). 100% of those women presented </span><span style="font-family:Verdana;">with vulvar lesions (mass or ulcer) had cancer. Positive predictive value (PPV)</span><span style="font-family:Verdana;"> of vulvar lesion alone was 1.25% but the probability of detection of a cancer dramatically increased when the lesion was accompanied with bleeding 35.2% or pain 26.9% respectively. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Presenting symptoms other than a lesion in the vulva as for example, soreness, irritation or bleeding was rarely associated with detection of cancer.</span></span></span>展开更多
Introduction Adenomyoepithelioma （AME） is uncommon characterized by biphasic proliferation of both epithelial and myoepithelial cells. More than half of the adenomyoepitheliomas （AME） are benign, but in rare insta...Introduction Adenomyoepithelioma （AME） is uncommon characterized by biphasic proliferation of both epithelial and myoepithelial cells. More than half of the adenomyoepitheliomas （AME） are benign, but in rare instances, it may become malignant. Malignant adenomyoepitheliomas almost always occur in the breast and salivary gland. They are unusual in vulva. We report this case and provide some information about symptoms, microstructure, treatment, and a discussion about this kind of disease.展开更多
Vulvar hematoma is an extremely rare complication outside obstetric practice<span><span><span><span>. Owing to the vulvar structure and its rich blood supply, hematoma can </span><span...Vulvar hematoma is an extremely rare complication outside obstetric practice<span><span><span><span>. Owing to the vulvar structure and its rich blood supply, hematoma can </span><span>reach an enormous size over a short period. Although direct trauma is the </span><span>anesthetic 31-year-old nullipara admitted for acute massive vulvar swelling as a complication of labiaplasty. She scored 10 on the pain scale. Upon admission to the emergency department, she had normal vital signs and was immediately started on intravenous acetaminophen and prophylactic antibiotics. The patient was subsequently transferred to the operating theater for examination and drainage of the hematoma under anesthesia. Reconstruction of the labia was performed. The patient had a smooth postoperative course and was discharged on the 3</span><sup><span>rd</span></sup><span> postoperative day. We concluded that Anesthetic gynecological procedures, although categorized as minor, can result in grave sequelae, and must therefore be performed in a hospital set-up.展开更多
Primary Ewing sarcoma (ES) and primitive neuroectodermal tumor (PNET) are considered as Ewing sarcoma family of tumors (ESFT), characterized by chromosomal translocation t(11;22) (q24;q12) leading to a chimeric transc...Primary Ewing sarcoma (ES) and primitive neuroectodermal tumor (PNET) are considered as Ewing sarcoma family of tumors (ESFT), characterized by chromosomal translocation t(11;22) (q24;q12) leading to a chimeric transcript EWS-FLI1 in 85% of cases. It typically involves the soft tissues of the chest wall, pelvis, paravertebral region, abdominal wall, retroperitoneal region and extremities in children, adolescents and young adults. It rarely occurs in the female genital tract. We report an extremely rare case of advanced vulvar Ewing sarcoma/PNET of the vulva confirmed by Fluorescence In Situ Hybridization (FISH) in a 30-year-old woman. The patient was treated by 6 cycles of chemotherapy followed by radiotherapy with favourable outcome.展开更多
Vulva Basal Cell Carcinoma (BCC) is a rare tumor. It usually occurs in Caucasians at an advanced age. We present a case of vulvar BCC in an African patient under 40 years old with HIV infection successfully treated su...Vulva Basal Cell Carcinoma (BCC) is a rare tumor. It usually occurs in Caucasians at an advanced age. We present a case of vulvar BCC in an African patient under 40 years old with HIV infection successfully treated surgically. This presentation is exceptional because of age, race, and the immune status of the patient.展开更多
Superficial angiomyxoma is a rare benign mesenchymal tumor that mainly occurs in the genital region. We report the case of a 51-year-old woman with a painless vulvar mass, well circumscribed on ultrasound. On gross fi...Superficial angiomyxoma is a rare benign mesenchymal tumor that mainly occurs in the genital region. We report the case of a 51-year-old woman with a painless vulvar mass, well circumscribed on ultrasound. On gross finding, it was a polypoid and bilobed mass, partially encapsulated. On histological examination, it was a proliferation of non-atypical spindle cells with an abundant, myxoid stroma and numerous medium-sized blood vessels. The diagnosis was superficial angiomyxoma. The clinical features do not often lead to the diagnosis of superficial vulvar angiomyxoma. It is based on histological examination and immunohistochemistry is helpful to differentiate it from other myxoid tumors.展开更多
The Object of the Study: The author of the given paper describes an unusual combination of two diseases: extramammary Paget’s disease manifested by intraepithelial adenocarcinoma of the vulva and anus combined with i...The Object of the Study: The author of the given paper describes an unusual combination of two diseases: extramammary Paget’s disease manifested by intraepithelial adenocarcinoma of the vulva and anus combined with invasive adenocarcinoma of the ampullary part of the rectum and describes the atypical manifestations of these diseases. The Content: The content of this research paper includes a description of the patient, an analysis of the clinical picture, diagnostic methods and therapeutic interventions used, a report of the following disease, and the result of the presented case. The Result of the Research Work: The result of the research work is the analysis of a clinical case with two different tumors, where such a combination of tumors is rarely described in the literature. Moreover, no large specific sample with this combination of diseases is available. Patient Characteristics: The given case report describes a patient of the Palliative Care Unit of the Gerontology Clinic with a primary diagnosis of C20-rectal adenocarcinoma in the background of the anal canal, perineal skin Paget’s disease, stage IV. The presented complications of the patient’s primary diagnosis are multiple metastases in the liver;status post palliative chemotherapy;hepatomegaly;metastases to abdominal lymph nodes, inguinal lymph nodes;metastases at Th12, L4 level;pain syndrome. The presented above combination of diagnosed diseases is very rare. Applied Diagnostics: In October 2021, it was performed diagnostic manipulation: biopsy and the pathologist have provided a microscopic description. The first tissue fragment had a pronounced electrothermal lesion and the epithelial structures were not valuable. The second skin tissue fragment was covered with hyperplastic and acanthotic epithelium;its basal and middle layers contained multiple large cells proliferates extending into the medial epidermis, and the cytoplasm of these cells reacted positively with PAS (Periodic Acid Schiff reaction). It needs to be noted that the patient had previously had several years of biopsies from the perineal and anal epidermis, where Paget’s disease had also been diagnosed. The performed immunohistochemistry showed these cells to be CK20 positive, CK7 rare positive and p16 negative. The following pathohistological findings were made: morphological and immunohistochemical picture is consistent with Paget’s disease. According to the ICD-10, the patient was diagnosed with C51 malignant neoplasm of the female external genitalia. Using imaging diagnostics, it became clear that the patient’s rectal adenocarcinoma had progressed to metastatic stage with distant liver metastases in the background of anal canal, perineal skin Paget’s disease. Therapeutic Plan of the Patient: Based on the patient’s main diagnoses, the complications of the principal diagnosis, the patient’s overall severe condition, pain syndrome, age and comorbidities, palliative chemotherapy was approved as a therapeutic option in council of doctors. Monitoring and Outcome of the Patient: The patient’s general condition was becoming worse over time, and she was diagnosed with exitus latalis in December 2022. At that time, the patient was discharged from hospital and was on palliative care at home under the control of her family physician.展开更多
Background:Although the most commonly recommended treatment for melanoma and extramammary Paget’s disease(EMPD)of the genital region is wide surgical excision of the lesion,the procedure is highly invasive and can le...Background:Although the most commonly recommended treatment for melanoma and extramammary Paget’s disease(EMPD)of the genital region is wide surgical excision of the lesion,the procedure is highly invasive and can lead to functional and sexual problems.Alternative treatments have been used for local control when wide local exci-sion was not feasible.Here,we describe four patients with genital malignancies who were treated with boron neutron capture therapy(BNCT).Methods:The four patients included one patient with vulvar melanoma(VM)and three with genital EMPD.They underwent BNCT at the Kyoto University Research Reactor between 2005 and 2014 using para-boronophenylalanine as the boron delivery agent.They were irradiated with an epithermal neutron beam between the curative tumor dose and the tolerable skin/mucosal doses.Results:All patients showed similar tumor and normal tissue responses following BNCT and achieved complete responses within 6 months.The most severe normal tissue response was moderate skin erosion during the first 2 months,which diminished gradually thereafter.Dysuria or contact pain persisted for 2 months and resolved com-pletely by 4 months.Conclusions:Treating VM and EMPD with BNCT resulted in complete local tumor control.Based on our clinical expe-rience,we conclude that BNCT is a promising treatment for primary VM and EMPD of the genital region.展开更多
Vulvar intraepithelial neoplasia （VIN） is a relatively uncommon disease that includes all of the precancerous lesions of vulvar malignancies with an incidence of approximately 2.5 per 100 000 women.In 2004,the Inter...Vulvar intraepithelial neoplasia （VIN） is a relatively uncommon disease that includes all of the precancerous lesions of vulvar malignancies with an incidence of approximately 2.5 per 100 000 women.In 2004,the International Society for the Study of Vulvovaginal Diseases （ISSVD） abolished the old VIN grading system and introduced a two-tier classification for squamous VIN：the usual type and the differentiated type;the term VIN applied only to histologically ＆quot;high-grade＆quot; squamous lesions （old terms VIN 2 and VIN 3）.1 The two types of VIN differ in etiology,morphology,biology,clinical features and malignant potential.The usual type VIN （uVIN）,which is associated with HPV infection,is the most comrnon subtype,accounting for more than 80% of all VIN cases.Currently,the old 3-grade system of the VIN terminology is still used in most of the hospitals in China.In this presentation,we categorized the patients with the ISSVD 2004 classification standard and attempted to describe the clinical features and the outcome of surgical treatment of uVIN using the retrospective data from three academic hospitals in China.展开更多
文摘Introduction: Invasive cancers of the vulva are uncommon;it is a pathology of the elderly. More and more young women are concerned. Objectives: To study and analyze vulvar cancer in our context. Patients and Method: Retrospective, descriptive and analytical study carried out in the Gynecology Department of the Owendo University Hospital over a period of 5 years from 2020 to 2024. All cancer cases of the period were concerned and we included vulvar cancers. We studied the epidemiological, clinical and therapeutic aspects. Results: We collected 5 files, the median age was 41.8 years [30 - 57 years], the average consultation time was 18 months [12 - 36 months]. Ulcerated, budding, and itchy lesions were present in 80% of cases. Invasive squamous cell carcinoma was the histological type present in all patients. Surgery was performed in 40% of cases. Concomitant radiochemotherapy (CRC) was offered in all patients. HIV was the comorbidity found in 100% of cases. Conclusion: Vulvar cancers are rare. They are often seen at advanced stages because of their location, the taboo nature they represent on the one hand and underdiagnosis on the other.
文摘OBJECTIVE: To clarify the role of midkine (MK) in vulvar carcinogenesis though examination of its expression in vulvar lesions including vulvar condyloma acuminata (VCA), vulvar intraepithelial neoplasia (VIN) and vulvar squamous cell carcinomas (VSCC), and to analyze the relationship between MK expression and human papilloma virus (HPV) infection. METHODS: Thirty VSCC, 15 VIN and 10 VCA patients were studied by streptavidin-biotin-immunoperoxidase method. MK expression was compared with clinicopathologic features of vulvar tumors. RESULTS: MK was expressed in 26 of 30 VSCC (87%), 3 of 5 VIN III and all VCA samples, whereas no MK expression was detected in the VIN I-II samples or in normal epithelium. The difference of MK expression between VIN III and VSCC was statistically significant (P
文摘In the present paper,444 patients with vulvar leukoplasia were treated by selectingacupoints in the local area and along the meridian plus Qugu（CV 2）and Huiyin（CV 1）and usingelectro-thermal needling.The total effective rate was up to 100.0％and the cure rate 87.3％.Theelectro-thermal effect directly acted on the affected area but strengthened the immunologic function ofthe whole body and raised the content of serum copper.
文摘Background:One of the biggest challenges in the swine industry is to increase female reproductive efficiency.Recently,vulva score categories(VSC),assessed prior to puberty,has been proposed as an indicator trait of efficient reproductive performance in sows.The objective of this study was to validate the use of VSC as an indicator trait for reproductive performance,and to perform genetic and genomic analyses for VSC.Methods:The phenotypic relationship of VSC,using a three-point scale:small(VSC-S),medium(VSC-M),and large(VSC-L),on reproductive performance was evaluated on three farms.VSC was measured at 15 weeks of age,for farms 1 and 2,and at 14 weeks of age for farm 3 on 3981 Yorkshire gilts,in which 1083 had genotypes(~50 K SNPs).Genetic parameters for VSC with reproductive traits were estimated using ssGBLUP.A Genome-wide association study(GWAS)for VSC was performed using BayesB.Results:For the phenotypic analysis of VSC across datasets,differences in performance were identified there was a significant effect(P≤0.05)for the interaction between Farm and VSC for total number dead(TND),and a trend(P<0.10)for total number born(TNB).There were significant(P≤0.05)pre-defined contrasts of VSC-S versus VSC-M+L on TNB,number born alive(NBA),TND,number of stillborn(NSB),and number of mummies(MUM).Heritability estimates for VSC as a categorical trait(VSCc)and a quantitative trait(VSCq)were 0.40±0.02 and 0.83±0.02,respectively,for across farm,0.13±0.07 and 0.20±0.10,respectively,for Farm1,0.07±0.07 and 0.09±0.09,respectively,for Farm2,and 0.20±0.03 and 0.34±0.05,respectively,for Farm3.For across farms,favorable genetic correlations estimates were found for TNB(0.28±0.19)and NBA(0.26±0.17).Within farms,moderate genetic correlations between VSC with reproductive traits were found for TNB(0.61±0.47)and MUM(0.69±0.47)for farm 1,for number of services until first farrow(NS;0.69±0.38)and unique service with successful first farrow(SFS;−0.71±0.38)for farm 3.Multiple genomic regions associated with VSCc were identified.Of these,a QTL located on chromosome 3 at 33–34Mb accounted for about 7.1%of the genetic variance for VSCc and VSCq.This region harbors the gene PRM1 that has been associated with early embryonic development in pigs.Conclusions:The results support potential of VSC for improved reproductive efficiency on first-parity performance,but the results might depend on the interaction between environmental factors and VSC,as well as potentially additive genetics.
文摘An ovarian malignant melanoma sometimes occurs from ovarian teratoma. Ovarian metastatic malignant melanoma is extremely rare. We describe a patient in whom vulvar melanoma (previously resected) metastasized to the ovary, making ovarian metastatic malignant melanoma. A 43-year-old Japanese woman was referred to us because of left ovarian tumor. She had undergone resection for malignant melanoma on the right labia minora with inguinal lymph node metastasis (pT1bN1aM0, stage IIIA, FIGO 2008). Eighteen months after this surgery, CT scans revealed left ovarian tumor and swelled pelvic lymph nodes, with a pelvic examination disclosing a left adnexal solid mass, with normal serum CA125 level (21.7 U/mL). Laparotomy revealed a left solid ovarian tumor measuring 4 cm, which was covered with a smooth grayish capsule. The right ovary, uterus, and pelvic cavity appeared normal. Upon sectioning during the surgery, the cross-sectional surface of the left ovary revealed a dark brown solid tumor. Following an intra-operative frozen-section diagnosis as metastatic melanoma, total hysterectomy with bilateral salpingo-oophorectomy and pelvic lymph dissection was performed. Histological examination confirmed the diagnosis as malignant melanoma metastasis to the left ovary and the obturator lymph node: the same laterality (left) as the primary site. The tumor was entirely composed of malignant melanoma cells with no evidence of teratoma. Combined chemotherapy with dabrafenib mesylate and trametinib was planned based on the positive BRAF mutations. This case highlights the importance that physicians should have high index of suspicion for the occurrence of ovarian melanoma metastasis after melanoma surgery. We also made extensive literature review on this issue, of which description may contribute to better understanding of this condition.
文摘Vulvar cancer is an uncommon tumor and represents 3%-5% of all female genital tract malignancies. Squamous cell carcinoma (SCC) is the most common carcinoma of the vulva. Distant metastasis of recurrent vulvar squamous cell carcinoma is rare and occurs late in the disease process. We report the first case of kidney metastasis from a vulvar squamous cell carcinoma in a 68-year-old Caucasian female. On initial presentation she was treated with radical vulvectomy, upper urethrectomy with bilateral inguinal and deep femoral lymph node dissection. She was staged as FIGO stage IVA and also received adjuvant chemo-radiation. She remained in remission for 24 months. Subsequently she was found to have a kidney tumor and underwent nephrectomy and was diagnosed with metastatic squamous cell carcinoma from the vulva to the kidney. In cases of recurrent vulvar carcinoma distant metastasis to the bones, breast, and brain is only rarely reported. Metastasis to kidneys from vulvar carcinoma is exceptionally rare with no reported cases in the literature. Renal metastasis should be considered in the differential diagnosis of kidney tumor in this group of women.
文摘Objective: To review our experience in diagnosis, pathology, treatment, and prognosis of extramammary Paget's disease of the vulva. Methods: Seven patients with vulvar Paget's disease who were treated at the Cancer Hospital cAMS were retrospectively reviewed for the period from 1960 to 2002. The symptoms, location of disease, pathology, mode of treatment and current status of the patients were evaluated. Results: A total of seven women with Paget抯 disease of the vulva were admitted to the Department of Gynecologic of Oncology. The mean age was 67.3 years (range 54~81 years). Vulvar lesion and pruritus were the common symptoms and it took average 3.4 years to confirm the diagnosis. All patients underwent surgery as initial treatment, vulvectomy was performed for 2 patients and radical vulvectomy plus groin node dissection for 5 patients. Two patients had invasive disease and four were associated with underlying adenocarcinoma. Five patients experienced recurrence, on average, 16.2 months after the surgery. Four of them underwent radiotherapy or chemotherapy and the other received no further treatment. The mean follow-up time was 41.1 months. Three patients, with invasive lesion or underlying adenocarcinoma were dead of the disease. Conclusion: There is a delay in the diagnosis of vulvar Paget's disease. The major treatment is surgery. Recurrence is relatively common. Patients with invasive disease or underlying carcinoma have a poor prognosis.
基金a grant from 11th five-year plan medical science project of PLA(No.06MA084)
文摘Objective： To analyze the clinicopathological features and differential diagnosis of angiomyofibroblastoma （AMFB） of the vulva. Methods： Two cases of AMFB were examined by light microscopy and immunohistochemical study and to discuss the clinicopathological features and differential diagnosis of AMFB with the reference to the literature. Results： Tumors were all circumscribed, and 〈5 cm in diameter. Microscopically, the tumors were composed of spindle or polygonal cells that were cellularly or hypocellularly arranged with perivascular accentuation in a mucoid or fibrocollagenous background. The tumors contained numerous small- to medium-sized blood vessels, which were characteristically thin walled. Immunohistochemically, two cases of tumor cells were positive for vimentin, SMA, CD34（＋） and FⅧ（＋）. Desmin and MSA were positive in one case; Cytokeratin, S-100, CD31 were negative in both. Conclusion： AMFB is a rare, benign soft tissue tumor that occurs in the genital tract of adult women. The origin remains unclear, but it is suggested that an origin from a perivascular pluripotent stem cell that is capable of myofibroblastoma differentiation. Angiomyofibroblastoma should be differentiated from other neoplasms of the vulva such as aggressive angiomyxoma, superficial angiomyxoma and cellular angiofibroma.
文摘Langerhans cell histiocytosis （LCH） of the female genital tract is rare. Only 20 cases of primary vulva LCH have been previously reported in the medical literature. In this report, we describe an additional case of LCH on the vulva. A 28-year-old Chinese woman presented with a two-year history of ulcerous lesions on the left vulva. No associated temperature, tiredness, or general malaise was observed. A diagnosis of LCH had been made by biopsy. Histological and immunohistochemical findings were characteristic of LCH. After two weeks of combined medical therapy, including interferon, prednisone, and methotrexate （MTX）, the lesion started to cicatrize. Now, the patient was well throughout a 18-month follow up, showing no symptoms or signs of local recurrence or systemic spread. The occurrence of LCH on the vulva is very unusual. It is necessary to perform a biopsy on the lesion, rule out the possibility of multiorgan involvement. There are no standard treatment options for this rare disease. The most effective treatment options remain elusive. In our case, combined medical therapy was proved to be effective.
文摘Object: To determine if vulvar melanosis progressed to melanoma over a period of 20 years or more. Methods: In 2010 the hospital records from the Royal Brisbane Hospital Vulvar Clinic between 1976 and 1988 were reviewed and cross checked with the state wide Queensland Centre for Gynaecological Cancer (QCGC) data base to determine if any patient had been lost to follow up and subsequently developed a vulvar melanoma. Data collected were stored and analysed using the computer software Statistical Package for the Social Sciences (SPSS) 11.0. Results: None of the 12 patients developed vulval melanoma in the years up to 2010. Conclusion: In this small group, followed for more than 20 years, melanosis was not a precursor of melanoma. One patient, who attended the Vulvar Clinic but was not included in this melanosis study, was found to have co-existing melanosis well away from her melanoma in situ and malignant melanoma at presentation. It was not possible to determine if these findings represented a progression of the benign to malignant. Biopsy of abnormal hyper pigmented vulvar skin is recommended. Current knowledge suggests that vulvar melanosis is a benign condition but to be on the safe side follow up of all hyper pigmented vulval lesions to detect early malignant change is recommended.
文摘Background: Vulva haematoma is an uncommon complication of childbirth that can cause maternal death if not properly managed. We present a case of large vulva haematoma managed conservatively with good outcome in UNTH Enugu. Clinical Presentation: This was a case of an unbooked 24 years old primiparous woman referred from a private hospital to UNTH, Enugu on account of left-sided vulva swelling of four hours duration following a spontaneous vaginal delivery of a live male baby that weighed 3.6 kilogrammes. She was given episiotomy which was repaired. Vaginal examination showed a swelling involving left labia majora and minora and extending to the perineal region and vagina. It measured 12 cm × 10 cm, firm and mildly tender. She was resuscitated with intravenous fluid, transfused with two units of blood and commenced on antibiotic and analgesic. The vulva haematoma was monitored and it remained the same size for two days, and then progressively regressed. She was discharged home on the 9th day. Conclusion: Conservative management of large vulva haematoma involving good counseling, correction of anaemia, institution of antibiotics, analgesic and close monitoring leads to effective resolution, reduced cost, scarring, pain and dyspareunia.
文摘<strong>Background:</strong> <span style="font-family:""><span style="font-family:Verdana;">The incidence of cancer vulva is increasing. 50% of cases are occurring at younger age especially the type related to Human Papilloma Virus infection. Cancer vulva can be prevented. Awareness of cancer vulva is deficient among women and healthcare providers. In this study we looked for a correlation between the most significant vulval symptoms to be associated with cancer vulva in order to educate women and to provide guidance for the health care providers. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> 569 women were enrolled in this observational cohort study. The patients were stratified according to their symptoms </span><span style="font-family:Verdana;">into 5 groups. Biopsy from the vulva, unless the lesion is obviously benign.</span> <b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Vulvar lesion, as a symptom (mass-ulcer), was significantly associat</span><span style="font-family:Verdana;">ed with detection of vulvar cancer (</span><i><span style="font-family:Verdana;">P</span></i><span> </span></span><span style="font-family:""><span style="font-family:Verdana;">≤ </span><span><span style="font-family:Verdana;">0.001). 100% of those women presented </span><span style="font-family:Verdana;">with vulvar lesions (mass or ulcer) had cancer. Positive predictive value (PPV)</span><span style="font-family:Verdana;"> of vulvar lesion alone was 1.25% but the probability of detection of a cancer dramatically increased when the lesion was accompanied with bleeding 35.2% or pain 26.9% respectively. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Presenting symptoms other than a lesion in the vulva as for example, soreness, irritation or bleeding was rarely associated with detection of cancer.</span></span></span>
文摘Introduction Adenomyoepithelioma （AME） is uncommon characterized by biphasic proliferation of both epithelial and myoepithelial cells. More than half of the adenomyoepitheliomas （AME） are benign, but in rare instances, it may become malignant. Malignant adenomyoepitheliomas almost always occur in the breast and salivary gland. They are unusual in vulva. We report this case and provide some information about symptoms, microstructure, treatment, and a discussion about this kind of disease.
文摘Vulvar hematoma is an extremely rare complication outside obstetric practice<span><span><span><span>. Owing to the vulvar structure and its rich blood supply, hematoma can </span><span>reach an enormous size over a short period. Although direct trauma is the </span><span>anesthetic 31-year-old nullipara admitted for acute massive vulvar swelling as a complication of labiaplasty. She scored 10 on the pain scale. Upon admission to the emergency department, she had normal vital signs and was immediately started on intravenous acetaminophen and prophylactic antibiotics. The patient was subsequently transferred to the operating theater for examination and drainage of the hematoma under anesthesia. Reconstruction of the labia was performed. The patient had a smooth postoperative course and was discharged on the 3</span><sup><span>rd</span></sup><span> postoperative day. We concluded that Anesthetic gynecological procedures, although categorized as minor, can result in grave sequelae, and must therefore be performed in a hospital set-up.
文摘Primary Ewing sarcoma (ES) and primitive neuroectodermal tumor (PNET) are considered as Ewing sarcoma family of tumors (ESFT), characterized by chromosomal translocation t(11;22) (q24;q12) leading to a chimeric transcript EWS-FLI1 in 85% of cases. It typically involves the soft tissues of the chest wall, pelvis, paravertebral region, abdominal wall, retroperitoneal region and extremities in children, adolescents and young adults. It rarely occurs in the female genital tract. We report an extremely rare case of advanced vulvar Ewing sarcoma/PNET of the vulva confirmed by Fluorescence In Situ Hybridization (FISH) in a 30-year-old woman. The patient was treated by 6 cycles of chemotherapy followed by radiotherapy with favourable outcome.
文摘Vulva Basal Cell Carcinoma (BCC) is a rare tumor. It usually occurs in Caucasians at an advanced age. We present a case of vulvar BCC in an African patient under 40 years old with HIV infection successfully treated surgically. This presentation is exceptional because of age, race, and the immune status of the patient.
文摘Superficial angiomyxoma is a rare benign mesenchymal tumor that mainly occurs in the genital region. We report the case of a 51-year-old woman with a painless vulvar mass, well circumscribed on ultrasound. On gross finding, it was a polypoid and bilobed mass, partially encapsulated. On histological examination, it was a proliferation of non-atypical spindle cells with an abundant, myxoid stroma and numerous medium-sized blood vessels. The diagnosis was superficial angiomyxoma. The clinical features do not often lead to the diagnosis of superficial vulvar angiomyxoma. It is based on histological examination and immunohistochemistry is helpful to differentiate it from other myxoid tumors.
文摘The Object of the Study: The author of the given paper describes an unusual combination of two diseases: extramammary Paget’s disease manifested by intraepithelial adenocarcinoma of the vulva and anus combined with invasive adenocarcinoma of the ampullary part of the rectum and describes the atypical manifestations of these diseases. The Content: The content of this research paper includes a description of the patient, an analysis of the clinical picture, diagnostic methods and therapeutic interventions used, a report of the following disease, and the result of the presented case. The Result of the Research Work: The result of the research work is the analysis of a clinical case with two different tumors, where such a combination of tumors is rarely described in the literature. Moreover, no large specific sample with this combination of diseases is available. Patient Characteristics: The given case report describes a patient of the Palliative Care Unit of the Gerontology Clinic with a primary diagnosis of C20-rectal adenocarcinoma in the background of the anal canal, perineal skin Paget’s disease, stage IV. The presented complications of the patient’s primary diagnosis are multiple metastases in the liver;status post palliative chemotherapy;hepatomegaly;metastases to abdominal lymph nodes, inguinal lymph nodes;metastases at Th12, L4 level;pain syndrome. The presented above combination of diagnosed diseases is very rare. Applied Diagnostics: In October 2021, it was performed diagnostic manipulation: biopsy and the pathologist have provided a microscopic description. The first tissue fragment had a pronounced electrothermal lesion and the epithelial structures were not valuable. The second skin tissue fragment was covered with hyperplastic and acanthotic epithelium;its basal and middle layers contained multiple large cells proliferates extending into the medial epidermis, and the cytoplasm of these cells reacted positively with PAS (Periodic Acid Schiff reaction). It needs to be noted that the patient had previously had several years of biopsies from the perineal and anal epidermis, where Paget’s disease had also been diagnosed. The performed immunohistochemistry showed these cells to be CK20 positive, CK7 rare positive and p16 negative. The following pathohistological findings were made: morphological and immunohistochemical picture is consistent with Paget’s disease. According to the ICD-10, the patient was diagnosed with C51 malignant neoplasm of the female external genitalia. Using imaging diagnostics, it became clear that the patient’s rectal adenocarcinoma had progressed to metastatic stage with distant liver metastases in the background of anal canal, perineal skin Paget’s disease. Therapeutic Plan of the Patient: Based on the patient’s main diagnoses, the complications of the principal diagnosis, the patient’s overall severe condition, pain syndrome, age and comorbidities, palliative chemotherapy was approved as a therapeutic option in council of doctors. Monitoring and Outcome of the Patient: The patient’s general condition was becoming worse over time, and she was diagnosed with exitus latalis in December 2022. At that time, the patient was discharged from hospital and was on palliative care at home under the control of her family physician.
基金study was supported by a Grant-in-aid for Scientific Research from the Japanese Ministry of Education,Culture,Sports,Science and Technology(Grant Number:25293267).
文摘Background:Although the most commonly recommended treatment for melanoma and extramammary Paget’s disease(EMPD)of the genital region is wide surgical excision of the lesion,the procedure is highly invasive and can lead to functional and sexual problems.Alternative treatments have been used for local control when wide local exci-sion was not feasible.Here,we describe four patients with genital malignancies who were treated with boron neutron capture therapy(BNCT).Methods:The four patients included one patient with vulvar melanoma(VM)and three with genital EMPD.They underwent BNCT at the Kyoto University Research Reactor between 2005 and 2014 using para-boronophenylalanine as the boron delivery agent.They were irradiated with an epithermal neutron beam between the curative tumor dose and the tolerable skin/mucosal doses.Results:All patients showed similar tumor and normal tissue responses following BNCT and achieved complete responses within 6 months.The most severe normal tissue response was moderate skin erosion during the first 2 months,which diminished gradually thereafter.Dysuria or contact pain persisted for 2 months and resolved com-pletely by 4 months.Conclusions:Treating VM and EMPD with BNCT resulted in complete local tumor control.Based on our clinical expe-rience,we conclude that BNCT is a promising treatment for primary VM and EMPD of the genital region.
文摘Vulvar intraepithelial neoplasia （VIN） is a relatively uncommon disease that includes all of the precancerous lesions of vulvar malignancies with an incidence of approximately 2.5 per 100 000 women.In 2004,the International Society for the Study of Vulvovaginal Diseases （ISSVD） abolished the old VIN grading system and introduced a two-tier classification for squamous VIN：the usual type and the differentiated type;the term VIN applied only to histologically ＆quot;high-grade＆quot; squamous lesions （old terms VIN 2 and VIN 3）.1 The two types of VIN differ in etiology,morphology,biology,clinical features and malignant potential.The usual type VIN （uVIN）,which is associated with HPV infection,is the most comrnon subtype,accounting for more than 80% of all VIN cases.Currently,the old 3-grade system of the VIN terminology is still used in most of the hospitals in China.In this presentation,we categorized the patients with the ISSVD 2004 classification standard and attempted to describe the clinical features and the outcome of surgical treatment of uVIN using the retrospective data from three academic hospitals in China.
