Vulva Squamous Cell Carcinoma

Squamous Cell Carcinoma

This represents 90% of vulvar malignant tumors. It is classified as: (i) Vulvar Intraepithelial Neoplasia (VIN), (Formerly Squamous Cell Carcinoma-in-situ or Bowen's Disease). With some risk of invasion and metastasis, or (ii) Invasive Squamous Cell Carcinoma. This is invasive and can metastasize.

(i) Vulvar intraepithelial squamous cell carcinoma (VIN). This is sub classified as: VIN I mild dysplasia, VIN II moderate dysplasia, VIN III severe dysplasia, carcinoma-in-situ, VIN III has 2 general patterns, multifocal and solitary.

Multifocal: Younger women, 20-50 years, associated with smoking and decreased immunity. Lesions may be itchy, irritating and are multiple, white, gray red or brown often warty. Associated with HPV type 16, 18 and less commonly types 31, 33, 35, 51 and 52

Solitary: Few symptoms. Gray warty lesions. Not usually associated with HPV. Diagnosis: Biopsy. Management: Surgery

(ii) Invasive Squamous Cell Carcinoma. This epidermal keratinocytic neoplasm is usually solitary on the vulva of patients over 55 years of age. NOTE: Can be associated with lichen sclerosus or lichen planus 0-40% of SCC of the vulva is associated with lichen sclerosus! The symptoms are bleeding, soreness and irritation.

Clinical: Lesions, often unifocal, 1-2 cm in diameter with erosions, ulceration, serosanguineous crusting, and tumor formation. Diagnosis: Biopsy Management: Surgery