Microinvasive carcinoma of the vulva. A report of two cases with regional lymph node metastasis.
Microinvasive squamous cell carcinoma of the vulva (invasion less than 5 mm) is a controversial concept. While initial observations did not identify regional lymph node metastases in patients with this lesion, 9.4% of all cases summarized from the literature have reported regional metastases. Presented here are two cases of poorly differentiated squamous cell carcinoma of the vulva (invasion of 2.0 and 3.0 mm) with lymph node metastases. Both patients' neoplasms consisted of a single focus of symmetrically expanding ("spray") carcinoma with infiltrating cords and isolated cells. While keratin formation was abundant, cytologic atypia was prominent. It is the authors' opinion that the degree of tumor differentiation, as judged by multiple parameters and pattern of invasion, is far more important than depth of invasion in predicting tumor behavior to determine therapy.
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness; D014846:Vulvar Neoplasms / Q000473:pathology*