Descriptive epidemiology of vulvar and vaginal cancers in Vaud, Switzerland, 1974-1994

Background: To analyse trends in incidence, survival and risk of second neoplasms following vaginal and vulvar cancers using data collected by the Swiss Cancer Registry of Vaud over the 21-year period 1974-1994. Materials and methods: Subjects were 257 vulvo-vaginal cancers. Of these, 69 were vaginal, 153 vulvar cancers, and 35 non-specified lower genital tract neoplasms; 94 in situ neoplasms were also registered (85 for the vulva). Results: Invasive vaginal cancer incidence decreased from 0.8 in 1974-1984 to 0.4/100,000 women in 1985-1994, while invasive vulvar cancer incidence remained approximately stable around 1.2/100,000 (world standard); incidence of in situ vulvar cancer increased from 0.8 to 1.3/100,000, the rise being larger in younger women. Significant excesses for second primary neoplasms were observed for oro-pharyngeal and lung cancer, and for non-melanomatous skin neoplasms, as well as for invasive vulvar cancers following in situ cancers. Conclusions: This population-based dataset confirms that the incidence of in situ vulvar (but not invasive vulvar or vaginal cancer) has been increasing over the last 20 years. The excess second primary neoplasms supports the hypotheses that human papillomavirus and cigarette smoking are related to vulvo-vaginal neoplasm

HPV Infection and Vulvar Cancer

Although the strong association between human papilloma virus (HPV) and cervical cancer has been widely demonstrated, it seems that uterine cervix cancer is not the only gynecologic malignancy induced by this pathogenic agent. It has been shown that HPV infection plays a central role in the development of vulvar cancer too, HPV 16 and 18 being the most frequently reported genotypes that might induce this kind of lesions. This aspect presents a particular importation, patients diagnosed with HPV-related vulvar cancer reporting a more favorable trend in regard with the long-term outcome. The current chapter aims to describe the pathogenesis as well as the therapeutic options and the long-term outcomes of patients in which association between HPV and vulvar cancer can be assessed

Patologias Vulvares que Necessitaram de Biopsia: Estudo Retrospetivo

Introduction: The vulvar area may be affected by many noninfectious conditions with similar clinical appearance, requiring a cutaneous biopsy. Our goal was to characterize the noninfectious vulvar diseases that required a biopsy in a southwestern Europe Central Hospital during a 10-year period. Methods: A retrospective study of all the noninfectious vulvar diseases with histological confirmation diagnosed in our institution was conducted between January 1, 2008 and December 31, 2017. Results: The sample included a total of 323 biopsies from 317 patients, aged between 11 and 98 years (mean age of 54.2 years). A total of 36 vulvar diseases was identified. Neoplastic conditions were the most frequently found, particularly melanotic macules (22.3%). The most frequent malignant tumor was vulvar intraepithelial neoplasia (6.2%) and squamous cell carcinoma (5.6%). The most common dermatosis was lichen sclerosus (12.7%). Conclusion: Neoplasms were the most frequently diagnosed conditions affecting the vulvar area that required a biopsy. Ruling out malignancy was also the main reason to perform a biopsy. This study highlights the variety of noninfectious diseases that may affect the vulva and require a biopsy. Since vulvar diseases may be serious and carry high levels of patient distress a correct understanding of these conditions is crucial.Introdução: Diversas patologias não infeciosas podem afetar a vulva, por vezes necessitando de realização de biopsia cutânea. O objetivo deste trabalho foi caracterizar todas as patologias vulvares não infeciosas em que foi realizada biopsia cutânea, num Hospital Central, durante um período de 10 anos. Métodos: Foi realizado um estudo retrospetivo de todas as patologias vulvares não infeciosas com confirmação histológica na nossa instituição, entre 1 de janeiro de 2008 e 31 de dezembro de 2017. Resultados: A amostra incluiu 323 biópsias de 317 doentes, entre os 11 e os 98 anos (média de idades de 54,2 anos), tendo sido identificadas 36 patologias distintas. As patologias neoplásicas foram as mais frequentes, nomeadamente as máculas pigmentadas da vulva (22,3%). A neoplasia maligna mais diagnosticada foi a neoplasia intraepitelial da vulva (6,2%) e o carcinoma espinocelular (5,6%). Já a dermatose inflamatória mais frequente foi o líquen escleroso (12,7%). Conclusão: A maior parte das biopsias envolveu patologias neoplásicas sendo a exclusão de malignidade o principal motivador da sua realização. Este estudo evidencia a grande diversidade de patologias não infeciosas que podem afetar a vulva e que são fonte de sofrimento e angústia, o que torna o seu correto diagnóstico e orientação essenciais

Trends in Net Survival from Vulvar Squamous Cell Carcinoma in Italy (1990–2015)

Objective: In many Western countries, survival from vulvar squamous cell carcinoma (VSCC) has been stagnating for decades or has increased insufficiently from a clinical perspective. In Italy, previous studies on cancer survival have not taken vulvar cancer into consideration or have pooled patients with vulvar and vaginal cancer. To bridge this knowledge gap, we report the trend in survival from vulvar cancer between 1990 and 2015. (2) Methods: Thirty-eight local cancer registries covering 49% of the national female population contributed the records of 6274 patients. Study endpoints included 1- and 2-year net survival (NS) calculated using the Pohar-Perme estimator and 5-year NS conditional on having survived two years (5|2-year CNS). The significance of survival trends was assessed with the Wald test on the coefficient of the period of diagnosis, entered as a continuous regressor in a Poisson regression model. (3) Results: The median patient age was stable at 76 years. One-year NS decreased from 83.9% in 1990–2001 to 81.9% in 2009–2015 and 2-year NS from 72.2% to 70.5%. Five|2-year CNS increased from 85.7% to 86.7%. These trends were not significant. In the age stratum 70–79 years, a weakly significant decrease in 2-year NS from 71.4% to 65.7% occurred. Multivariate analysis adjusting for age group at diagnosis and geographic area showed an excess risk of death at 5|2-years, of borderline significance, in 2003–2015 versus 1990–2002. (4) Conclusions: One- and 2-year NS and 5|2-year CNS showed no improvements. Current strategies for VSCC control need to be revised both in Italy and at the global level

Buschke-Lowenstein Tumor

Giant Condyloma acuminatum (GCA) , or Buschke-Lowenstein tumor (BLT), is a slow-growing, locally destructive, rare tumor that may occur in the anogenital region and it is related to human papillomavirus (HPV), which was first described by Buschke - Lowenstein in 1925. After consulting the databases of Latin American and Caribbean Literature (LILACS) and International Literature in Health Sciences and Biomedical (PubMed), without temporal delimitation or study design, using the MeSH terms "vulvar neoplasms," "giant condyloma of Buschke and Lowenstein", "condylomata acuminate”, we found 24 articles. After exclusion of the articles that did not address the BLT, it remained ten cases reported in the literature. We reported a case of BLT that clashes with the profile described in the literature. Consent was obtained from the patient for publication of the case and images