[Diagnosis and management of vulvar intraepithelial neoplasias and invasive vulvar cancers].
OBJECTIVE
Update on the diagnosis and management of vulvar intraepithelial neoplasia (VIN) and vulvar carcinoma.


METHODS
Review of the literature.


RESULTS
The classification of VIN is leaning towards the development of two distinct anatomoclinical models. VIN of the usual type and of a differentiated type. New forms of treatment of preinvasive lesions that are less traumatic and as efficient will have to be evaluated in the future such as immunomodulators and photodynamic therapy. The invasive carcinoma is generally rapidly symptomatic and visible; however, more than one third of patients are still diagnosed at an advanced stage. New therapeutic alternatives are being examined such as the sentinel lymph node in early stages and the preoperative radiochemotherapy in advanced stages.


CONCLUSIONS
VIN and vulvar cancer need specialized treatment which may be mutilating, despite the fact that therapeutic options are well defined today and tend towards less aggressive surgery.
Sauthier
Philippe
P
Service de gynécologie oncologique, Département d'obstétrique et gynécologie, Centre hospitalier de l'Université de Montréal, Montréal, Canada. philippe.sauthier@umontreal.ca
Petignat
Patrick
P
D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy; D014844:Vulva / Q000473:pathology; D014846:Vulvar Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy