Histopathologic study of thin vulvar squamous cell carcinomas and associated cutaneous lesions: a correlative study of 48 tumors in 44 patients with analysis of adjacent vulvar intraepithelial neoplasia types and lichen sclerosus

The American Journal of Surgical Pathology
Andres Chiesa-VotteroWilliam R Hart

Abstract

A series of 48 excised thin (<or=5 mm in tumor thickness) invasive squamous cell carcinomas (SCCs) of the vulva in 44 patients were studied to determine the interrelationships of tumor type with type of adjacent vulvar intraepithelial neoplasia (VIN) and lichen sclerosus. The SCCs were of conventional keratinizing type in 38 tumors (79%), warty type in 6 (13%), and basaloid type in 4 (8%). VIN adjacent to SCC was found in 37 (77%) of the tumors. Of these, 19 were classic VIN (51%) and 18 were simplex (differentiated) VIN (49%). All 10 warty and basaloid SCCs had adjacent classic VIN. Of the 38 keratinizing SCCs, 27 (71%) had adjacent VIN, consisting of simplex VIN in 67% and classic VIN in 33%. The median age of the patients with classic VIN, simplex VIN, and no VIN were 62, 78, and 75 years, respectively. In the overall statistical analysis, the differences between the VIN types and the types of SCC were highly significant. In pairwise comparisons, significant differences in SCC type were found when the classic VIN group was compared with the simplex VIN group and when the classic VIN group was compared with the no VIN group. In contrast, no difference was found when the simplex VIN group was compared with the no VIN group. Li...Continue Reading

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