DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20205237

5-year experience with vulval lesions in a tertiary care hospital: series of 115 cases

Ritu Bhat, Sachin Kolte

Abstract


Background: Wide range of vulval lesions have been described with similar modes of presentation. Benign and inflammatory lesions form the major chunk. Squamous cell carcinoma is the most reported malignant entity. Aim was to review the vulval lesions received in our department

Methods: We studied the data from the archives of the Department of Pathology for a period of 5 years from January 2014 to December 2018 for vulval biopsies and specimens sent for histopathological examination. The final diagnoses were divided into non-neoplastic, neoplastic and non- specific.

Results: Age of women ranged from 22 to 86 years (mean 54.3±3.6) with the maximum number of patients between 50 to 60 years of age. Most common form of clinical presentation was an itchy white elevated lesion on the vulva (72 cases, 62.6%). The most common site for the lesions was labia minora (90 cases, 78.2%). Non neoplastic lesions were seen in 53 cases and neoplastic lesions were seen in 52 cases. There were 28 (53.8%) benign lesions while 24 cases (46.1%) were malignant. Squamous cell carcinoma was the most frequently diagnosed form accounting for 20 cases (83.3%). Rare tumours like Malignant melanoma, Merkel cell carcinoma and Neuroendocrine carcinoma formed 16.6% (n=4). Seven cases were premalignant. Two cases had non-specific histologic diagnosis showing mild chronic inflammation.

Conclusions: Previous studies have reported that non-neoplastic lesions form around 70% of cases. However, in our study we found that the non-neoplastic and neoplastic lesions form equal number of cases (46%) which may be attributed to increased awareness or geographical variation.


Keywords


Vulval lesions, Squamous cell carcinoma, Neuroendocrine carcinoma, Malignant melanoma

Full Text:

PDF

References


Ozdemir O, Sari ME, Ertugrul FA, Sen E, Ilgin BU, Atalay C. Spectrum of Vulvar Lesions in an Obstetrics and Gynecology Outpatient Clinic. Medic Sci. 4(1):1876-84.

Kahramanoglu I, Turan H, Oner YO, Bese T, Ilvan S, Arvas M, et al. A Very Rare Case: HPV-Negative Vulvar Cancer in an Adolescent. Ca Repor Obstet Gynecol. 2018;2018.

Sokol AI, Sokol ER. General gynecology: the requisites in obstetrics and gynecology. Elsev Heal Sci. 2007.

Foster DC. Vulvar disease. Obstet Gynecol. 2002;100(1):145-63.

Doyen J, Demoulin S, Delbecque K, Goffin F, Kridelka F, Delvenne P. Vulvar skin disorders throughout lifetime: about some representative dermatoses. Bio Med Res Int. 2014;2014.

Mohan H, Kundu R, Arora K, Punia RS, Huria A. Spectrum of vulvar lesions: a clinicopathologic study of 170 cases. Int J Reprod Contracept Obstet Gynecol. 2014;3(1):175-80.

Iyengar S, Acheson N. Premalignant vulval conditions. Obstet Gynaecol Reprod Med. 2008;18(3):60-3.

Bowen AR, Vester A, Marsden L, Florell SR, Sharp H, Summers P. The role of vulvar skin biopsy in the evaluation of chronic vulvar pain. Am J Obstet Gynecol. 2008;199(5):467-e1.

Kelekci KH, Adamhasan F, Gencdal S, Sayar H, Kelekci S. The impact of the latest classification system of benign vulvar diseases on the management of women with chronic vulvar pruritus. Ind J Dermatol, Venereol, Leprol. 2011;77(3):294.

Fatoohi BY. Collins test in patients with vulvar pruritus. Int J Gynaecol Obstet. 2009;104(1):76.

Acheson N, Ganesan R, Chan KK. Premalignant vulvar disorders. Curr Obstet Gynaecol. 2000;10(1):12-7.

Del Pino M, Rodriguez-Carunchio L, Ordi J. Pathways of vulvar intraepithelial neoplasia and squamous cell carcinoma. Histopathology 2013;62(1):161-75.

Westermann C, Fischer A, Clad A. Treatment of vulvar intraepithelial neoplasia with topical 5% imiquimod cream. Int J Gynaecol Obstet. 2013;120(3):266-70.

Robinson Z, Edey K, Murdoch J. Invasive vulval cancer. Obstet Gynaecol Reprod Med. 2011;21(5):129-36.

Judson PL, Habermann EB, Baxter NN. Trends in the incidence of invasive and in situ vulvar carcinoma. Obstet Gynecol. 2006;107:1018-22.