Vulvar squamous cell carcinoma and lichen sclerosus.
There are two clinicopathological types of vulvar squamous cell carcinoma, human papillomavirus (HPV)-positive and HPV-negative, which can be distinguished to some degree on routine histology. Human papillomavirus-positive carcinomas account for one-quarter to one-third of cases, occur in women on average 20 years younger than in HPV-negative, and are associated with multiple lower genital tract neoplasia. Human papillomavirus negative carcinoma is linked to lichen sclerosus. Of all carcinomas, 7-96% show lichen sclerosus in skin adjacent to the carcinoma, the majority being the first presentation of lichen sclerosus, and up to 5% of patients with lichen sclerosus develop carcinoma after long-term follow up. Where lichen sclerosus is associated with malignancy, it is often hyperplastic, may show a subtle form of intraepithelial neoplasia termed 'differentiated vulvar intraepithelial neoplasia', and may lose its pathognomonic oedematous-hyaline layer. The local additional factors causing lichen sclerosus to develop malignancy on the vulva are not known.
Scurry
J P
JP
Mercy Hospital for Women, East Melbourne, Victoria, Australia.
Vanin
K
K
D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000209:etiology / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D018459:Lichen Sclerosus et Atrophicus / Q000209:etiology / Q000473:pathology*; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000473:pathology*; D011379:Prognosis; D018570:Risk Assessment; D014412:Tumor Virus Infections / Q000175:diagnosis / Q000473:pathology*; D014846:Vulvar Neoplasms / Q000209:etiology / Q000473:pathology*