vulvar intraepithelial neoplasia
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Introduction
Dysplastic or neoplastic changes in the vulvar squamous epithelium.
Etiology
Epidemiology
- most often occurs in postmenopausal women[2]
Clinical manifestations
- most patients are asymptomatic
- pruritus is the most common symptom
- well circumscribed rough, keratinized white lesions
- dark-brown macular lesion of the labia minora
- red, brown, gray, black or hyperpigmented lesions may also be present
- may be unifocal or multifocal
- lesions are generally raised, but may be macular
- vulvar macular erythema is one presentation
- dysuria or pain on urination may result from contact of urine with the abnormal vulva (GRS9)[1]
Laboratory
- biopsy confirms diagnosis
- several biopsies may be required[1]
Management
- wide local excision
- imiquimod 5% often effective in HPV-positive women
- prognosis: rarely a precursor to invasive disease
More general terms
References
- ↑ 1.0 1.1 1.2 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
Geriatric Review Syllabus (GRS12) Colburn JL, Westcott AM, Potter JF (eds) American Geriatrics Society. 2025 - ↑ 2.0 2.1 Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
- ↑ ACOG Committee Opinion No. 509: Management of vulvar intraepithelial neoplasia. Obstet Gynecol. 2011 Nov;118(5):1192-4 PMID: https://pubmed.ncbi.nlm.nih.gov/22015906
- ↑ Lawrie TA, Nordin A, Chakrabarti M, et al. Medical and surgical interventions for the treatment of usual-type vulval intraepithelial neoplasia. Cochrane Database Syst Rev. 2016;2016(1):CD011837 PMID: https://pubmed.ncbi.nlm.nih.gov/26728940 PMCID: PMC6457805 Free PMC article. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011837.pub2/full
- ↑ Ayala M, Fatehi M. Vulvar Intraepithelial Neoplasia. In: StatPearls [Internet]. StatPearls Publishing; 2023 https://www.ncbi.nlm.nih.gov/books/NBK540982/
- ↑ Dockery LE, Soper JT. Vulvar intraepithelial neoplasia: a review of the disease and current management. Obstet Gynecol Surv. 2021 Jan;76(1):55-62 PMID: https://pubmed.ncbi.nlm.nih.gov/33506879
- ↑ Kesic V, Carcopino X, Preti M et al The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) consensus statement on the management of vaginal intraepithelial neoplasia. Int J Gynecol Cancer. 2023 Apr 3;33(4):446-461 PMID: https://pubmed.ncbi.nlm.nih.gov/36958755 PMCID: PMC10086489 Free PMC article. Review.