Intraoperative lymphatic mapping and sentinel node identification: gynecologic applications.

The status of regional lymph nodes is a powerful predictor of survival in patients with early cancers of the vulva, cervix, and uterus. Radical resection of vulvar and cervix cancers along with extensive lymphadenectomy remains the standard of care for these cancers. Intraoperative lymphatic mapping and sentinel node identification has the potential to improve the treatment of patients with gynecologic cancer with improved detection of lymph node metastases and reduced morbidity. This chapter will focus primarily on vulvar cancer and include a review of previous innovations in treatment and current experience with intraoperative lymphatic mapping in these patients.

A lost piece of melanoma history.

The original descriptions of melanoma of the hand, foot, vulva, and metastatic melanoma to the heart and bowel were by Jean Cruveilhier in his Anatomie Pathologique du Corps Humains published between 1829 and 1842. Cruveilhier's descriptions predate publications currently ascribed as being the first case reports of these melanomas. Cruveilhier's atlas of pathology also contains the original descriptions of multiple sclerosis, hypertrophic pyloric stenosis, and gastric ulcers. Cruveilhier's work is well known to book collectors, but his melanoma discoveries have not been cited since Pemberton in 1858. Cruveilhier's case reports are reviewed in addition to a discussion of their significance and historical contexts. Current melanoma scholars will appreciate this lost piece of melanoma history with its early historical discoveries and magnificent illustrations.

[Intraepithelial squamous cell carcinoma of the vulva, 1972-1989]. / Carcinoma escamoso intraepitelial de la vulva, 1972-1989.

We report our experience about intraepithelial squamous carcinoma of the vulva, consisting of 20 cases with clinical and histopathological diagnosis, at the University of Chile Clinical Hospital. Between december 1972 and october 1989. The age of patients was between 30 and 78 years old, median age 57.6 years old. Clinical HPV infection was detected in three cases (15%) 17 patients were submitted to simple total, vulvectomy (94.5%) without operatory mortality. The follow-up was between 3 months and 11 years (mean follow-up 6.5 years). Recurrence was observed in 2 patients (11.1%) of the 18 submitted to treatment.

Vulvar intraepithelial neoplasia: historical aspects and current status.

Vulvar intraepithelial neoplasia (VIN) is the currently accepted generic designation for the spectrum of vulvar lesions with the histologic features of squamous dysplasia and squamous cell carcinoma in situ. Although several classifications of VIN have been espoused in the past 20 years, VIN can be readily classified into two principal clinicopathologic types: classic (bowenoid) VIN and simplex (differentiated) VIN. This manuscript summarizes the historical development and current status of our knowledge about VIN. Information on the clinical and pathologic aspects are detailed and illustrated, as are considerations of differential diagnosis.