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1.
Medicine (Baltimore) ; 100(10): e25047, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725889

RESUMO

RATIONALE: Nevus sebaceous (NS) is a lesion caused by congenital hyperplastic disorder of the sebaceous glands. It commonly noted in the scalp and face and rarely in the trunk, neck, or oral mucosa. We present a rare case of a lesion arising in the genital region. PATIENT CONCERNS: A 47-year-old woman complained of a gradual increase in the size of her bilateral labia minora over 2 years, which affected her sexual life and caused walking difficulty. She was admitted to the Department of Obstetrics and Gynecology. On physical examination, no ulcer, discharge, and vulval or vaginal bleeding were found. The bilateral inguinal lymph nodes were not palpable, bilateral labia minora were asymmetric, and the right side was evidently bigger than the left. The labia minora had serrated edges and numerous papillae with a maximum diameter of 0.5 cm. The vagina, cervix, and uterus with its attachments were normal. Blood samples tested negative for human immunodeficiency virus, human papilloma virus, hepatitis B virus, and hepatitis C virus. DIAGNOSIS: A diagnosis of NS of the bilateral labia minora was made following histopathological examination of the resected specimen. INTERVENTION: The bilateral labia minora lesions were resected general anesthesia on August 29, 2016. The operation was successful, and intraoperative blood loss was about 10 ml. OUTCOMES: After 40 months of postoperative follow-up, no recurrence or appearance of other tumors were noted. LESSONS: We recommend surgical removal of lesions in the genital area during adolescence or before adulthood. Adolescence may be the best period for surgical intervention owing to a greater risk of malignant change in adulthood. On the other hand, surgical risk should be avoided in children considering the low incidence of malignant transformation.


Assuntos
Nevo/diagnóstico , Neoplasias das Glândulas Sebáceas/diagnóstico , Neoplasias Vulvares/diagnóstico , Diagnóstico Diferencial , Feminino , Procedimentos Cirúrgicos em Ginecologia , Humanos , Pessoa de Meia-Idade , Nevo/patologia , Nevo/cirurgia , Neoplasias das Glândulas Sebáceas/patologia , Neoplasias das Glândulas Sebáceas/cirurgia , Glândulas Sebáceas/patologia , Glândulas Sebáceas/cirurgia , Sífilis/diagnóstico , Vulva/patologia , Neoplasias Vulvares/patologia , Neoplasias Vulvares/cirurgia
2.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431442

RESUMO

Fibroepithelial polyps are benign lesions that may appear in the vulvovaginal region. They usually occur in women of reproductive age and tend to grow up to 5 cm, but there are some rare cases in which they grow up to 20 cm. We report a case of a 22-year-old woman in the third trimester of her first pregnancy with spontaneous bleeding from a pedunculated mass measuring 15 cm in the widest diameter on the right side of the vulva. Features of this case are discussed as well as its implications, especially regarding the decision of labour. Due to the big size of the mass and its propensity to bleed, we decided to perform an elective caesarean section as well as its excision.


Assuntos
Neoplasias Fibroepiteliais/diagnóstico , Pólipos/diagnóstico , Complicações Neoplásicas na Gravidez/diagnóstico , Hemorragia Uterina/etiologia , Neoplasias Vulvares/diagnóstico , Cesárea , Feminino , Humanos , Recém-Nascido , Neoplasias Fibroepiteliais/complicações , Neoplasias Fibroepiteliais/patologia , Neoplasias Fibroepiteliais/cirurgia , Pólipos/complicações , Pólipos/patologia , Pólipos/cirurgia , Gravidez , Complicações Neoplásicas na Gravidez/patologia , Complicações Neoplásicas na Gravidez/cirurgia , Terceiro Trimestre da Gravidez , Resultado do Tratamento , Hemorragia Uterina/cirurgia , Vulva/patologia , Vulva/cirurgia , Neoplasias Vulvares/complicações , Neoplasias Vulvares/patologia , Neoplasias Vulvares/cirurgia , Adulto Jovem
3.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431446

RESUMO

Primary Bartholin gland carcinoma (BGC) is an extremely rare disease. It typically presents in elderly women. It can be confused with Bartholin gland cyst, which is a benign condition leading to a delay in diagnosis and treatment. We are presenting a case report of BGC in a 35-year-old woman, which has created a diagnostic as well as therapeutic dilemma.


Assuntos
Glândulas Vestibulares Maiores/patologia , Carcinoma/diagnóstico , Cistos/diagnóstico , Doenças Raras/diagnóstico , Neoplasias Vulvares/diagnóstico , Adulto , Idade de Início , Glândulas Vestibulares Maiores/diagnóstico por imagem , Glândulas Vestibulares Maiores/cirurgia , Carcinoma/patologia , Carcinoma/cirurgia , Cistos/patologia , Cistos/cirurgia , Feminino , Humanos , Imagem por Ressonância Magnética , Pré-Menopausa , Doenças Raras/patologia , Doenças Raras/cirurgia , Neoplasias Vulvares/patologia , Neoplasias Vulvares/cirurgia
5.
Pathologe ; 42(1): 116-124, 2021 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-33346872

RESUMO

Primary vaginal carcinoma is rare. There are two pathogenetic pathways, one associated with HPV high-risk infection and another one with inactivation of p53. Vaginal Paget's disease is rare and mostly associated with vulvar disease or represents intravaginal spread of associated locoregional cancer. Diagnostic vaginal biopsies should be examined by step sections on H&E. Sentinel lymph nodes should be processed completely using ultrastaging. Morphology-based prognostic factors with good clinical evidence are tumour stage and lymph node status. Molecular markers are not currently relevant for treatment decision and prognosis.


Assuntos
Carcinoma in Situ , Patologia Cirúrgica , Neoplasias Vaginais , Neoplasias Vulvares , Feminino , Humanos , Estadiamento de Neoplasias , Prognóstico , Biópsia de Linfonodo Sentinela , Neoplasias Vaginais/diagnóstico , Neoplasias Vaginais/patologia , Neoplasias Vulvares/diagnóstico , Neoplasias Vulvares/patologia
6.
J Cancer Res Clin Oncol ; 146(10): 2535-2545, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32656663

RESUMO

INTRODUCTION: Since the community spread of Coronavirus disease 2019 (COVID-19), the practice of oncologic care at our comprehensive cancer center has changed. Postponing cancer treatment without consideration of its implications could cost more lives than can be saved. In this special situation, we must continue to provide our cancer patients with the highest quality of medical services assuring the safety. This article provides general guidance on supporting curative treatment strategies in vulvar cancer patients. METHODS: At our institution, a vulvar cancer multidisciplinary team (Vul.Can MDT) of specialists is responsible for personalized treatment of this disease. The phase 2 period necessarily requires specific procedures for both outpatient and inpatient pathways and to provide strategies concerning the management of vulvar cancer patients even in case of an eventually concomitant SARS-CoV-2 infection. In brief, an accurate remote and in person triage must be provided routinely and patients submitted to specific diagnostic tests prior to every major treatment or procedure (surgery, RT, and CT) or in case of suspicion for COVID-19 syndrome. The decisional workflow for these women often old and frail, have been rapidly adjusted by our Vul.Can MDT to mitigate the potential risks of COVID-19. RESULTS: The team produced two types of recommendations concerning: (1) safety regulations of care pathways, patients and health care providers, (2) personalized treatment strategies. We present a protocol that can be applied in clinical practice: the flowcharts provided, include the modulation of treatment intensity designed for surgical procedures and radiation, stratified for FIGO stage of disease and intention. CONCLUSION: We suggest that our proposals are applicable in this setting of patients, considering anyway current international recommendations and guidelines.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Procedimentos Clínicos , Pneumonia Viral/epidemiologia , Padrões de Prática Médica , Medicina de Precisão , Neoplasias Vulvares/epidemiologia , Tomada de Decisão Clínica , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Gerenciamento Clínico , Feminino , Humanos , Pandemias , Equipe de Assistência ao Paciente , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , Neoplasias Vulvares/complicações , Neoplasias Vulvares/diagnóstico , Neoplasias Vulvares/terapia , Fluxo de Trabalho
7.
Oncology ; 98(8): 513-519, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32408297

RESUMO

Background and summary: Among all vulvar cancers, primary adenoid cystic carcinoma (ACC) of Bartholin's gland is a very rare tumor characterized by a slow growth, a high local aggressiveness, and a remarkable recurrence rate. Due to its rarity, treatment remains a challenge for oncologists and gynecological surgeons. Key message: The present paper reports clinical, radiological, and histological features of ACC of Bartholin's gland and reviews the literature data on the treatment options with a particular focus on the potential role of particle radiation therapy.


Assuntos
Glândulas Vestibulares Maiores/patologia , Carcinoma Adenoide Cístico/patologia , Carcinoma Adenoide Cístico/radioterapia , Neoplasias Vulvares/patologia , Neoplasias Vulvares/radioterapia , Carcinoma Adenoide Cístico/diagnóstico , Carcinoma Adenoide Cístico/tratamento farmacológico , Feminino , Radioterapia com Íons Pesados/métodos , Humanos , Recidiva Local de Neoplasia , Prognóstico , Doenças Raras/diagnóstico , Doenças Raras/patologia , Doenças Raras/radioterapia , Fatores de Risco , Neoplasias Vulvares/diagnóstico , Neoplasias Vulvares/tratamento farmacológico
8.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(4): 306-312, mayo 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-196440

RESUMO

ANTECEDENTES Y OBJETIVOS: Existen pocos estudios sobre la enfermedad de Paget extramamaria (EPEM) en la población mediterránea. Nuestro objetivo fue revisar las características de nuestros pacientes con EPEM, su asociación con neoplasia en continuidad y su evolución a largo plazo. PACIENTES Y MÉTODOS: Realizamos un estudio observacional retrospectivo sobre 27 pacientes diagnosticados de EPEM entre 1990-2015. Las historias clínicas fueron revisadas retrospectivamente para obtener los datos clínico-patológicos y de seguimiento. RESULTADOS: Se trata de 20 mujeres y 7 varones de entre 42 y 88 años de edad (mediana de 76 años). Las lesiones se localizaron en la vulva (16 casos), en el pubis-región inguinal (5), en la región perianal (4) y en la axila (2). El tiempo de evolución al diagnóstico osciló entre 1 y 60 meses (mediana de 12 meses) y el diámetro máximo entre 20 y 140 mm (mediana de 55 mm). En 3 casos (11,1%) la EPEM fue secundaria. Ningún caso se desarrolló sobre adenocarcinoma anexial cutáneo previo. Diez de 24 EPEM primarias (41,7%) presentaban invasión de la dermis. Ocho de los 27 pacientes (29,6%) presentaron recidiva local tras el tratamiento quirúrgico inicial. Tres pacientes (11,1%) fallecieron a consecuencia de metástasis de la EPEM. CONCLUSIONES: La presencia de un adenocarcinoma anexial cutáneo subyacente es poco frecuente pero no es rara la existencia de un adenocarcinoma extracutáneo en continuidad. A pesar de que la EPEM suele evolucionar lentamente, es frecuente la invasión de la dermis y no son excepcionales las metástasis. Las recidivas locales son frecuentes a pesar de la extirpación con márgenes amplios y pueden ser tardías, por lo que es preciso un seguimiento a largo plazo


BACKGROUND AND OBJECTIVE: Extramammary Paget disease (EMPD) has seldom been studied in Mediterranean populations. We aimed to review the characteristics of our patients with EMPD, the presence of a neoplasm in continuity, and the long-term course of the disease. PATIENTS AND METHODS: Retrospective observational study of 27 patients diagnosed with EMPD between 1990 and 2015. All clinical and pathology findings related to clinical course and outcomes were retrieved for analysis. RESULTS: Twenty patients were women and 7 were men. Ages ranged from 42 to 88 years (median, 76 years). Lesions were in the following locations: vulva (16 cases), pubis-groin (5), perianal region (4), and axilla (2). Time from onset to diagnosis ranged from 1 to 60 months (median, 12 months) and maximum lesion diameter from 20 to 140 mm (median, 55 mm). In 3 cases (11.1%) EMPD was a secondary condition. None of the lesions developed on a previous cutaneous adnexal adenocarcinoma. Ten of the 24 primary EMPDs (41.7%) invaded the dermis. Eight of the 27 patients (29.6%) experienced local recurrence after the initial surgical treatment.Three patients (11.1%) died as a consequence of metastasis from the EMPD. CONCLUSIONS: The presence of an underlying cutaneous adnexal adenocarcinoma is uncommon, but it is not unusual to find an extracutaneous adenocarcinoma in continuity. Although EMPD is a slow-growing tumor, dermal invasion is frequent and metastasis is not uncommon. Local recurrence is common even after excision with wide margins and may be delated, so long term follow-up is essential


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doença de Paget Extramamária/diagnóstico , Doença de Paget Extramamária/terapia , Neoplasias Vulvares/diagnóstico , Neoplasias Vulvares/terapia , Neoplasias das Glândulas Anais/diagnóstico , Neoplasias das Glândulas Anais/terapia , Axila , Estudos Retrospectivos , Recidiva
10.
Medicina (B Aires) ; 80(2): 127-133, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32282317

RESUMO

Squamous cell carcinoma of the vulva may develop in association or independently of HPV infection. The relationship between pathogenesis, classification, immunohistochemical profile and prognosis has been studied in the literature with some discrepancies. The aim of this study was to observe the classical association of keratinizing carcinomas with the absence of HPV infection and warty and basaloid carcinomas with the presence of this virus. Therefore, we reviewed the clinic, morphology, and immunophenotype of 39 cases. The tumors were histologically classified into classic keratinizing squamous carcinoma (30), warty (5) and basaloid (4). In the statistical analysis, diffuse expression with p16 was significantly associated with younger age (p = 0.0025), presence of high-grade intraepithelial lesion (p < 0.0001), koilocytosis (p = 0.02), and morphological subtype (p = 0.02), and was inversely associated with the expression of p53 (p < 0.0001) and the presence of lichen sclerosus (p = 0.0051). It is curious that 4 keratinizing carcinomas of the cases studied presented coexpression of p16 and p53. Only one warty tumor was negative for p16 and positive for p53, and 9 keratinizing tumors were positive for p16 and negative for p53. Although these findings show that the use of hematoxylin and eosin could correctly define tumors associated with HPV, we strongly suggest the performance of immunohistochemistry, especially in squamous keratinizing classic carcinomas in young patients with a history of HPV.


Assuntos
Carcinoma de Células Escamosas/metabolismo , Imuno-Histoquímica , Proteína Supressora de Tumor p53/metabolismo , Neoplasias Vulvares/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais , Carcinogênese , Carcinoma de Células Escamosas/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Papillomaviridae , Infecções por Papillomavirus , Neoplasias Vulvares/diagnóstico , Verrugas
11.
Ann Agric Environ Med ; 27(1): 123-128, 2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32208590

RESUMO

INTRODUCTION AND OBJECTIVE: Lymph node involvement is a strong predictor of disease recurrence and patient survival in vulvar cancer. The aim of the study was to evaluate the feasibility of sentinel lymph node (SLN) screening, the incidence of skip metastases, and lymph node lymphangiogenesis. MATERIAL AND METHODS: Fifty-five patients participated in this prospective, single centre study. A double SLN screening method was employed using radiocolloid (technetium-99 sulfur colloid) and 1.0% Isosulfan Blue. Immunohistochemistry, using a mouse monoclonal antibody against D2-40, was used to evaluate lymphatic vessel density (LVD). All calculations were performed using STATISTICA software v. 10 (StatSoft, USA, 2011); p < 0.05 was considered significant. RESULTS: Using both methods of SLN detection, 100% accuracy was achieved, and skip metastases were diagnosed in only one woman (1.82%). Peri-tumour median LVD was significantly increased compared with matched intra-tumour samples (p < 0.001), while median LVD was significantly lower in negative, compared with positive SLN, regardless of whether matched non-SLN were negative (p < 0.001) or positive (p = 0.005). Metastatic SLN exhibited significantly higher median LVD compared with matched negative non-SLN (p = 0.015), while no significant difference in median LVD was detected between positive SLN and matched positive non-SLN. However, negative SLN had a significantly higher median LVD compared with matched negative non-SLN (p = 0.012). CONCLUSIONS: SLN detection is a safe and feasible procedure in vulvar cancer. In patients without nodular involvement, SLN, compared with non-SLN, exhibited significantly higher median LVD, which may be an indication of its preparation to host metastases, and thus requires further investigation.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Linfangiogênese , Metástase Linfática/diagnóstico , Linfonodo Sentinela/patologia , Neoplasias Vulvares/diagnóstico , Idoso , Animais , Anticorpos Monoclonais Murinos , Carcinoma de Células Escamosas/patologia , Feminino , Virilha , Humanos , Imuno-Histoquímica , Camundongos , Estadiamento de Neoplasias , Estudos Prospectivos , Corantes de Rosanilina , Coloide de Enxofre Marcado com Tecnécio Tc 99m , Neoplasias Vulvares/patologia
12.
Gynecol Oncol ; 157(2): 463-468, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32107046

RESUMO

PURPOSE: Colposcopy-guided punch biopsy is a cornerstone method for diagnosing vulvar diseases. The aim of this study was to evaluate the concordance rate of clinical findings in vulvar diseases during examinations, in comparison with colposcopy-directed punch biopsy. We also developed a new classification to simplify the categorization of vulvoscopic findings. METHODS: The concordance rate of the clinical findings was compared with the final histology results from punch biopsies. The data were collected between January 2014 and May 2017 at the Erlangen University Hospital. RESULTS: A total of 482 colposcopy-directed punch biopsies of the vulva were obtained in 420 women. The overall concordance rate of the clinical findings in comparison with the histological vulvar punch-biopsy findings was 53.9% for all entities - benign lesions, lichen, low- and high-grade squamous intraepithelial lesions (LSIL/HSILs), and vulvar carcinoma. The concordance rate for detecting LSILs was 64.3% (45/70). The concordance rate for detecting HSILs was 62.3% and for Vulvar carcinoma 65.2%. CONCLUSIONS: Punch biopsy of suspicious lesions continues to be a cornerstone in diagnosing HSILs and carcinoma of the vulva. Careful work-up of the vulva is recommended when patients have symptoms such as pruritus or pain. The new classification is more specific for diagnosing lesions in the vulva.


Assuntos
Carcinoma in Situ/diagnóstico , Neoplasias Vulvares/diagnóstico , Adulto , Biópsia/métodos , Carcinoma in Situ/patologia , Colposcopia/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias Vulvares/patologia
13.
Diagn Pathol ; 15(1): 3, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31915021

RESUMO

BACKGROUND: Myoepithelioma-like tumor of the vulvar region (MELTVR) is a recently described mesenchymal neoplasm which typically arising in vulvar regions of adult women. CASE PRESENTATION: Here we report a case of a 65-year-old woman who presented with a 6-year history of subcutaneous mass in the vulvar region. The mass had recently increased in size continuously. Histologically, the tumor cells had an epithelioid to spindled shape. Epithelioid tumor cells proliferated singly or in a loosely cohesive manner with myxoid areas, while spindled tumor cells grew in diffuse sheets or storiform arrangements mainly in nonmyxoid areas. Immunohistochemically, the tumor cells were positive for vimentin, epithelial membrane antigen, calponin, and were partially mild to moderate positive for estrogen receptor, but completely negative for S100 protein, glial fibrillary acidic protein, CD34, desmin, SMA and cytokeratin. INI1/SMARCB1 expression was deficient. EWSR1 and FUS genes were intact tested by fluorescence in situ hybridization analysis. Based on these findings, we diagnose this case as MELTVR. The patient remained relapse-free after the lesion was widely excised during 8 months follow-up. CONCLUSIONS: This disease should be included in the differential diagnostic list of vulvar tumors with epithelioid to spindled morphology. Recognition of its histopathological features and immunohistochemical reactivity will help to understand the tumor better.


Assuntos
Biomarcadores Tumorais/análise , Mioepitelioma/diagnóstico , Neoplasias Vulvares/diagnóstico , Idoso , China , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Mioepitelioma/patologia , Proteína SMARCB1/genética , Proteína SMARCB1/metabolismo , Neoplasias Vulvares/patologia
14.
J Low Genit Tract Dis ; 24(1): 53-60, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31860576

RESUMO

OBJECTIVES: A subset of vulvar carcinomas (VC) are associated with human papillomavirus (HPV) DNA. This trait can be used to identify tumor markers for patient's follow-up. A large diversity of HPV prevalence in VC has been reported, but no data are available concerning the insertional HPV status in this tumor type. Therefore, we have used an innovative next generation sequencing (NGS)-based CaptHPV method able to provide an extensive characterization of HPV DNA in tumors. MATERIAL AND METHODS: Tumor tissue specimens from 55 patients with VC were analyzed using p16 immunohistochemistry, in situ hybridization, polymerase chain reaction, and CaptHPV-NGS assays. RESULTS: Our analyses showed that 8 (14.5%) of 55 cases were associated with HPV 16 DNA. No other HPV genotypes were identified. The HPV genome was in a free episomal state only in one case and both episomal and integrated into the tumor cell genome in 7. There was a single insertion in 5 cases and multiple sites, scattered at different chromosomal loci in two. ISH data suggest that some of these might reflect tumor heterogeneity. Viral integration targeted cellular genes among which were TP63, CCDC148, LOC100133091, PKP1, and POLA2. Viral integration at the PKP1 locus was associated with partial gene deletion, and no PKP1 protein was detected in tumor tissue. CONCLUSIONS: Using the NGS-based innovative capture-HPV approach, we established a cartography of HPV 16 DNA in 8 VC cases and identified novel genes targeted by integration that may be used as specific tumor markers. In addition, we established a rationale strategy for optimal characterization of HPV status in VC.


Assuntos
Biomarcadores Tumorais/análise , Carcinoma/diagnóstico , DNA Viral/genética , Sequenciamento de Nucleotídeos em Larga Escala , Papillomavirus Humano 16/genética , Integração Viral , Neoplasias Vulvares/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/patologia , Carcinoma/virologia , DNA Viral/química , Feminino , Marcadores Genéticos , Humanos , Pessoa de Meia-Idade , Neoplasias Vulvares/patologia , Neoplasias Vulvares/virologia
15.
Clin Exp Dermatol ; 45(2): 187-193, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31389062

RESUMO

BACKGROUND: Vulvar melanoma (VM) is rare and is often diagnosed late. Dermoscopy may aid in its recognition, differentiating VM from other more common vulvar lesions, such as melanosis and naevi. However, little is known about the dermoscopic features of thin VM. AIM: To retrospectively analyse a series of histopathologically diagnosed thin VMs and to highlight their most suggestive dermoscopic features. METHODS: A multicentre, retrospective study was conducted, including histopathologically proven thin VMs, either intraepidermal or with Breslow thickness ≤ 0.5 mm, diagnosed during the period 2016-2018. We particularly focused on their dermoscopic characteristics to highlight the most suggestive dermoscopic diagnostic clues. RESULTS: In total, 14 cases of early-stage VM were included, in women with a mean age at diagnosis of 64.86 years. The most frequently affected sites were the labia minora. Of these, 11 cases were unifocal. Dermoscopy most often revealed structureless areas, grey globules and areas, irregular black-brown dots, blue and white structures, and red areas. CONCLUSIONS: In our experience, early-stage VM often exhibits dermoscopic features that are more typical of thicker cutaneous melanomas. Dermoscopy may provide useful clues for the prompt diagnosis of thin VM.


Assuntos
Dermoscopia , Melanoma/patologia , Vulva/patologia , Neoplasias Vulvares/patologia , Idoso , Idoso de 80 Anos ou mais , Dermoscopia/métodos , Feminino , Genitália Feminina/patologia , Humanos , Melanoma/diagnóstico , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias Vulvares/diagnóstico
17.
BMJ Case Rep ; 12(12)2019 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-31818892

RESUMO

Leiomyoma, a benign monoclonal tumour, is very rarely found in extrauterine sites, especially in the vulval region. Histopathology of the soft tissue tumours affecting this region is similar and immunohistochemistry (IHC) may be essential to confirm the diagnosis. We report a case of a 63-year-old postmenopausal woman who presented with a recurrent vulval mass involving the clitoris and left labia majora with suspected urethral involvement. Although the wedge biopsy was reported as peripheral nerve sheath tumour, staining with smooth muscle actin clinched the diagnosis of leiomyoma, highlighting the importance of IHC for diagnosis.


Assuntos
Erros de Diagnóstico , Leiomioma/diagnóstico , Recidiva Local de Neoplasia/diagnóstico , Neoplasias da Bainha Neural/diagnóstico , Neoplasias Vulvares/diagnóstico , Feminino , Humanos , Imuno-Histoquímica , Leiomioma/patologia , Leiomioma/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Resultado do Tratamento , Neoplasias Vulvares/patologia , Neoplasias Vulvares/cirurgia
19.
BMJ Case Rep ; 12(11)2019 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-31712227

RESUMO

A 33-year-old woman presented for a preoperative examination prior to an upcoming operative hysteroscopy. During the examination, a firm 1 cm mass in her right labia minora was noted. The mass was excised in the operating room without difficulty. Pathological examination revealed a benign phyllodes tumour of the vulva. Phyllodes tumours are uncommon fibroepithelial tumours primarily found in the breast although rarely may present as a vulvar lesion. Phyllodes tumours of the vulva are rarely reported in the literature, with only 17 previously reported cases. This case represents the first reported case of a phyllodes tumour occurring in the labia minora. While most of these tumours are benign, it is important to keep these and other rare tumours in the differential diagnosis of vulvar masses. Even with benign tumours, continued surveillance for recurrence should be performed.


Assuntos
Tumor Filoide/diagnóstico , Neoplasias Vulvares/diagnóstico , Adulto , Feminino , Humanos , Achados Incidentais , Resultado do Tratamento
20.
Diagn Pathol ; 14(1): 125, 2019 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-31699107

RESUMO

BACKGROUND: Vulvar extramammary Paget disease is a rare chronic condition, that presents with non-specific symptoms such as pruritus and eczematous lesions. Because most of these lesions are noninvasive, the distinction between primary and secondary Paget disease is crucial to management. CASE PRESENTATION: We report an unusual case of vulvar Paget disease associated with massive dermal vascular embolization, cervicovaginal involvement and metastasis to inguinal and retroperitoneal lymph nodes. The intraepithelial vulvar lesion had a classical appearance and was accompanied by extensive component of dermal lymphovascular tumor emboli, similar to those observed in inflammatory breast carcinoma. Immunohistochemical analysis revealed that the lesion was secondary to high-grade urothelial cell carcinoma. The patient had a history of superficial low-grade papillary urothelial carcinoma of the bladder, which had appeared 2 years before the onset of vulvar symptoms. CONCLUSIONS: Eczematoid vulvar lesions merit careful clinical examination and biopsy, including vulva mapping and immunohistochemistry. The information obtained may help to define and classify a particular presentation of Paget disease. Noninvasive primary lesions do not require the same aggressive approaches required for the treatment of invasive and secondary disease.


Assuntos
Carcinoma de Células de Transição/patologia , Embolia/etiologia , Doença de Paget Extramamária/patologia , Neoplasias Urológicas/patologia , Neoplasias do Colo do Útero/patologia , Neoplasias Vulvares/patologia , Biomarcadores Tumorais/análise , Carcinoma de Células de Transição/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Doença de Paget Extramamária/diagnóstico , Neoplasias Urológicas/diagnóstico , Neoplasias Vulvares/diagnóstico
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