Abstract
Squamous carcinoma of the vulva and vagina is increasing in incidence and appears to be related to HPV infection in younger women and chronic irritation in older women. Individualized treatment aims to prevent unnecessary surgery by recognizing early stage disease amenable to simple excision and is focusing on sentinel node analysis for vulval cancer. Care must be taken to distinguish squamous carcinoma from benign mimics such as wart, verruca vulgaris, herpes simplex, hyperplasia, keratoacanthoma, verruciform xanthoma, papillomatosis, and polyps. Basal cell carcinoma of the vulva is a rare disease that must be separated from squamous carcinoma in order to prevent overtreatment.
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Japaze H, Garcia-Bunuel R, Woodruff JD. Primary vulvar neoplasia: a review of in situ and invasive carcinoma, 1935–1972. Obstet Gynecol. 1977;49(4):404–11.
Herod JJ, Shafi MI, Rollason TP, Jordan JA, Luesley DM. Vulvar intraepithelial neoplasia: long term follow up of treated and untreated women. Br J Obstet Gynaecol. 1996;103(5):446–52.
Tavassoli FA, Devilee P. Pathology and genetics of tumours of the breast and female genital organs. WHO Classification of tumours. Lyon: IARC Press; 2003.
Chiesa-Vottero A, Dvoretsky PM, Hart WR. 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. Am J Surg Pathol. 2006;30(3):310–8.
Husseinzadeh N, Wesseler T, Schneider D, Schellhas H, Nahhas W. Prognostic factors and the significance of cytologic grading in invasive squamous cell carcinoma of the vulva: a clinicopathologic study. Gynecol Oncol. 1990;36(2):192–9.
Andreasson B, Nyboe J. Value of prognostic parameters in squamous cell carcinoma of the vulva. Gynecol Oncol. 1985;22(3):341–51.
Broders A. Squamous cell epithelioma of the skin. A study of 256 cases. Ann Surg. 1921;73:141–60.
Trimble CL, Hildesheim A, Brinton LA, Shah KV, Kurman RJ. Heterogeneous etiology of squamous carcinoma of the vulva. Obstet Gynecol. 1996;87(1):59–64.
Santos M, Montagut C, Mellado B, Garcia A, Ramon y Cajal S, Cardesa A, et al. Immunohistochemical staining for p16 and p53 in premalignant and malignant epithelial lesions of the vulva. Int J Gynecol Pathol. 2004;23(3):206–14.
Steeper TA, Piscioli F, Rosai J. Squamous cell carcinoma with sarcoma-like stroma of the female genital tract. Clinicopathologic study of four cases. Cancer. 1983;52(5):890–8.
Al-Ghamdi A, Freedman D, Miller D, Poh C, Rosin M, Zhang L, et al. Vulvar squamous cell carcinoma in young women: a clinicopathologic study of 21 cases. Gynecol Oncol. 2002;84(1):94–101.
Choo YC. Invasive squamous carcinoma of the vulva in young patients. Gynecol Oncol. 1982;13(2):158–64.
Carter J, Carlson J, Fowler J, Hartenbach E, Adcock L, Carson L, et al. Invasive vulvar tumors in young women – a disease of the immunosuppressed? Gynecol Oncol. 1993;51(3):307–10.
Mousavi A, Abbasi F, Abadi AG, Hashemi FA. Vulvar squamous cell carcinoma associated with Fanconi’s anemia. Int J Hematol. 2010;91(3):498–500.
Volgger B, Marth C, Zeimet A, Muller-Holzner E, Ruth N, Dapunt O. Fulminant course of a microinvasive vulvar carcinoma in an immunosuppressed woman. Gynecol Oncol. 1997;65(1):177–9.
Caterson RJ, Furber J, Murray J, McCarthy W, Mahony JF, Sheil AG. Carcinoma of the vulva in two young renal allograft recipients. Transplant Proc. 1984;16(2):559–61.
Leckie GB, Cotton RE. Simultaneous in situ carcinoma of the cervix, vulva and perineum after immunosuppressive therapy for renal transplantation. Br J Obstet Gynaecol. 1977;84(2):143–8.
Brown JE, Sunborg MJ, Kost E, Cosin JA, Winter 3rd WE. Vulvar cancer in human immunodeficiency virus-seropositive premenopausal women: a case series and review of the literature. J Low Genit Tract Dis. 2005;9(1):7–10.
Preston M. Squamous cell carcinoma of the vulva presenting amongst gigantic vulval warts. J Obstet Gynaecol. 2005;25(3):316.
Choi DS, Lee JW, Lee SJ, Choi CH, Kim TJ, Lee JH, et al. Squamous cell carcinoma with sarcomatoid features of the vulva: a case report and review of literature. Gynecol Oncol. 2006;103(1):363–7.
Santeusanio G, Schiaroli S, Anemona L, Sesti F, Valli E, Piccione E, et al. Carcinoma of the vulva with sarcomatoid features: a case report with immunohistochemical study. Gynecol Oncol. 1991;40(2):160–3.
Beller U, Quinn MA, Benedet JL, Creasman WT, Ngan HY, Maisonneuve P, et al. Carcinoma of the vulva. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet. 2006;95 Suppl 1:S7–27.
CRUK. Vulval cancer – UK incidence statistics. 2010. http://info.cancerresearchuk.org/cancerstats/types/vulva/incidence/#Worldwide. Accessed in 2011.
CRUK. Vulval cancer – UK incidence statistics. 2010. http://info.cancerresearchuk.org/cancerstats/types/vulva/incidence/#Worldwide. Accessed in 2011.
Joura EA, Losch A, Haider-Angeler MG, Breitenecker G, Leodolter S. Trends in vulvar neoplasia. Increasing incidence of vulvar intraepithelial neoplasia and squamous cell carcinoma of the vulva in young women. J Reprod Med. 2000;45(8):613–5.
Sankaranarayanan R, Ferlay J. Worldwide burden of gynaecological cancer: the size of the problem. Best Pract Res Clin Obstet Gynaecol. 2006;20(2):207–25.
Piura B, Rabinovich A, Cohen Y, Friger M, Glezerman M. Squamous cell carcinoma of the vulva in the south of Israel: a study of 50 cases. J Surg Oncol. 1998;67(3):174–81.
Vandborg MP, Christensen RD, Kragstrup J, Edwards K, Vedsted P, Hansen DG, et al. Reasons for diagnostic delay in gynecological malignancies. Int J Gynecol Cancer. 2011;21(6):967–74.
Ansink A. Vulvar squamous cell carcinoma. Semin Dermatol. 1996;15(1):51–9.
Coleman RL, Santoso JT. Vulvar carcinoma. Curr Treat Options Oncol. 2000;1(2):177–90.
Armes JE, Lourie R, Bowlay G, Tabrizi S. Pagetoid squamous cell carcinoma in situ of the vulva: comparison with extramammary paget disease and nonpagetoid squamous cell neoplasia. Int J Gynecol Pathol. 2008;27(1):118–24.
Bakour SH, Jaleel H, Weaver JB, Kehoe S, Radcliffe KW. Vulvar carcinoma presenting during pregnancy, associated with recurrent bone marrow hypoplasia: a case report and literature review. Gynecol Oncol. 2002;87(2):207–9.
Heller DS, Cracchiolo B, Hameed M, May T. Pregnancy-associated invasive squamous cell carcinoma of the vulva in a 28-year-old. HIV-negative woman. A case report. J Reprod Med. 2000;45(8):659–61.
Regan MA, Rosenzweig BA. Vulvar carcinoma in pregnancy: a case report and literature review. Am J Perinatol. 1993;10(4):334–5.
Chan JK, Sugiyama V, Pham H, Gu M, Rutgers J, Osann K, et al. Margin distance and other clinico-pathologic prognostic factors in vulvar carcinoma: a multivariate analysis. Gynecol Oncol. 2007;104(3):636–41.
Tantipalakorn C, Robertson G, Marsden DE, Gebski V, Hacker NF. Outcome and patterns of recurrence for International Federation of Gynecology and Obstetrics (FIGO) stages I and II squamous cell vulvar cancer. Obstet Gynecol. 2009;113(4):895–901.
Kumar S, Shah JP, Bryant CS, Imudia AN, Morris RT, Malone Jr JM. A comparison of younger vs older women with vulvar cancer in the United States. Am J Obstet Gynecol. 2009;200(5):e52–5.
Nicoletto MO, Parenti A, Del Bianco P, Lombardi G, Pedrini L, Pizzi S, et al. Vulvar cancer: prognostic factors. Anticancer Res. 2010;30(6):2311–7.
Rhodes CA, Cummins C, Shafi MI. The management of squamous cell vulval cancer: a population based retrospective study of 411 cases. Br J Obstet Gynaecol. 1998;105(2):200–5.
Husseinzadeh N, Zaino R, Nahhas WA, Mortel R. The significance of histologic findings in predicting nodal metastases in invasive squamous cell carcinoma of the vulva. Gynecol Oncol. 1983;16(1):105–11.
Drew PA, al-Abbadi MA, Orlando CA, Hendricks JB, Kubilis PS, Wilkinson EJ. Prognostic factors in carcinoma of the vulva: a clinicopathologic and DNA flow cytometric study. Int J Gynecol Pathol. 1996;15(3):235–41.
Ansink A, Mooi WJ, van Doornewaard G, van Tinteren H, Heintz AP, Ivanyi D. Cytokeratin subtypes and involucrin in squamous cell carcinoma of the vulva. An immunohistochemical study of 41 cases. Cancer. 1995;76(4):638–43.
Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet. 2009;105(2):103–4.
Oonk MH, Hollema H, de Hullu JA, van der Zee AG. Prediction of lymph node metastases in vulvar cancer: a review. Int J Gynecol Cancer. 2006;16(3):963–71.
Ndubisi B, Kaminski PF, Olt G, Sorosky J, Singapuri K, Hackett T, et al. Staging and recurrence of disease in squamous cell carcinoma of the vulva. Gynecol Oncol. 1995;59(1):34–7.
van der Velden J, van Lindert AC, Lammes FB, ten Kate FJ, Sie-Go DM, Oosting H, et al. Extracapsular growth of lymph node metastases in squamous cell carcinoma of the vulva. The impact on recurrence and survival. Cancer. 1995;75(12):2885–90.
Fons G, Hyde SE, Buist MR, Schilthuis MS, Grant P, Burger MP, et al. Prognostic value of bilateral positive nodes in squamous cell cancer of the vulva. Int J Gynecol Cancer. 2009;19(7):1276–80.
Raspagliesi F, Hanozet F, Ditto A, Solima E, Zanaboni F, Vecchione F, et al. Clinical and pathological prognostic factors in squamous cell carcinoma of the vulva. Gynecol Oncol. 2006;102(2):333–7.
Emanuels AG, Burger MP, Hollema H, Koudstaal J. Quantitation of proliferation-associated markers Ag-NOR and Ki-67 does not contribute to the prediction of lymph node metastases in squamous cell carcinoma of the vulva. Hum Pathol. 1996;27(8):807–11.
Gordinier ME, Steinhoff MM, Hogan JW, Peipert JF, Gajewski WH, Falkenberry SS, et al. S-Phase fraction, p53, and HER-2/neu status as predictors of nodal metastasis in early vulvar cancer. Gynecol Oncol. 1997;67(2):200–2.
Lerma E, Matias-Guiu X, Lee SJ, Prat J. Squamous cell carcinoma of the vulva: study of ploidy, HPV, p53, and pRb. Int J Gynecol Pathol. 1999;18(3):191–7.
Preti M, Ronco G, Ghiringhello B, Micheletti L. Recurrent squamous cell carcinoma of the vulva: clinicopathologic determinants identifying low risk patients. Cancer. 2000;88(8):1869–76.
Gonzalez Bosquet J, Magrina JF, Gaffey TA, Hernandez JL, Webb MJ, Cliby WA, et al. Long-term survival and disease recurrence in patients with primary squamous cell carcinoma of the vulva. Gynecol Oncol. 2005;97(3):828–33.
Horn LC, Wagner S. Frozen section analysis of vulvectomy specimens: results of a 5-year study period. Int J Gynecol Pathol. 2010;29(2):165–72.
Konanahalli P, Menon P, Walsh MY, McCluggage WG. Enterobious vermicularis (pinworm) infestation of the vulva: report of 2 cases of a pseudoneoplastic lesion mimicking squamous carcinoma. Int J Gynecol Pathol. 2010;29(5):490–3.
Buckley CH, Butler EB, Fox H. Vulvar intraepithelial neoplasia and microinvasive carcinoma of the vulva. J Clin Pathol. 1984;37(11):1201–11.
Wilkinson EJ, Rico MJ, Pierson KK. Microinvasive carcinoma of the vulva. Int J Gynecol Pathol. 1982;1(1):29–39.
Wells M, Jenkins M. Selected topics in the histopathology of the vulva. Curr Diagn Pathol. 1994;1:41–7.
Vernooij F, Sie-Go DM, Heintz AP. Lymph node recurrence following stage IA vulvar carcinoma: two cases and a short overview of literature. Int J Gynecol Cancer. 2007;17(2):517–20.
Sidor J, Diallo-Danebrock R, Eltze E, Lelle RJ. Challenging the concept of microinvasive carcinoma of the vulva: report of a case with regional lymph node recurrence and review of the literature. BMC Cancer. 2006;6:157.
Van Der Velden J, Kooyman CD, Van Lindert AC, Heintz AP. A stage Ia vulvar carcinoma with an inguinal lymph node recurrence after local excision. A case report and literature review. Int J Gynecol Cancer. 1992;2(3):157–9.
Atamdede F, Hoogerland D. Regional lymph node recurrence following local excision for microinvasive vulvar carcinoma. Gynecol Oncol. 1989;34(1):125–8.
Hicks ML, Hempling RE, Piver MS. Vulvar carcinoma with 0.5 mm of invasion and associated inguinal lymph node metastasis. J Surg Oncol. 1993;54(4):271–3.
Schausberger C, Six L, Horvat R, Joura EA. Groin metastasis after extensive microinvasive vulvar cancer. A case report. J Reprod Med. 2007;52(2):78–80.
Figge DC, Tamimi HK, Greer BE. Lymphatic spread in carcinoma of the vulva. Am J Obstet Gynecol. 1985;152(4):387–94.
Gonzalez Bosquet J, Magrina JF, Magtibay PM, Gaffey TA, Cha SS, Jones MB, et al. Patterns of inguinal groin metastases in squamous cell carcinoma of the vulva. Gynecol Oncol. 2007;105(3):742–6.
Berchuck A, Rodriguez G, Kamel A, Soper JT, Clarke-Pearson DL, Bast Jr RC. Expression of epidermal growth factor receptor and HER-2/neu in normal and neoplastic cervix, vulva, and vagina. Obstet Gynecol. 1990;76(3 Pt 1):381–7.
Oonk MH, de Bock GH, van der Veen DJ, Ten Hoor KA, de Hullu JA, Hollema H, et al. EGFR expression is associated with groin node metastases in vulvar cancer, but does not improve their prediction. Gynecol Oncol. 2007;104(1):109–13.
Ambros RA, Malfetano JH, Mihm Jr MC. Clinicopathologic features of vulvar squamous cell carcinomas exhibiting prominent fibromyxoid stromal response. Int J Gynecol Pathol. 1996;15(2):137–45.
de Hullu JA, Oonk MH, van der Zee AG. Modern management of vulvar cancer. Curr Opin Obstet Gynecol. 2004;16(1):65–72.
Crosbie EJ, Slade RJ, Ahmed AS. The management of vulval cancer. Cancer Treat Rev. 2009;35(7):533–9.
de Hullu JA, Doting E, Piers DA, Hollema H, Aalders JG, Koops HS, et al. Sentinel lymph node identification with technetium-99m-labeled nanocolloid in squamous cell cancer of the vulva. J Nucl Med. 1998;39(8):1381–5.
Crosbie EJ, Winter-Roach B, Sengupta P, Sikand KA, Carrington B, Murby B, et al. The accuracy of the sentinel node procedure after excision biopsy in squamous cell carcinoma of the vulva. Surg Oncol. 2010;19(4):e150–4.
Hampl M, Hantschmann P, Michels W, Hillemanns P. Validation of the accuracy of the sentinel lymph node procedure in patients with vulvar cancer: results of a multicenter study in Germany. Gynecol Oncol. 2008;111(2):282–8.
Puig-Tintore LM, Ordi J, Vidal-Sicart S, Lejarcegui JA, Torne A, Pahisa J, et al. Further data on the usefulness of sentinel lymph node identification and ultrastaging in vulvar squamous cell carcinoma. Gynecol Oncol. 2003;88(1):29–34.
Moore RG, Granai CO, Gajewski W, Gordinier M, Steinhoff MM. Pathologic evaluation of inguinal sentinel lymph nodes in vulvar cancer patients: a comparison of immunohistochemical staining versus ultrastaging with hematoxylin and eosin staining. Gynecol Oncol. 2003;91(2):378–82.
Tamussino KF, Bader AA, Lax SF, Aigner RM, Winter R. Groin recurrence after micrometastasis in a sentinel lymph node in a patient with vulvar cancer. Gynecol Oncol. 2002;86(1):99–101.
de Hullu JA, van der Zee AG. Tammussino et al.: groin recurrence after micrometastasis in a sentinel lymph node in a patient with vulvar cancer. Gynecol Oncol. 2003;89(1):189–90; author reply 191.
Knopp S, Holm R, Trope C, Nesland JM. Occult lymph node metastases in early stage vulvar carcinoma patients. Gynecol Oncol. 2005;99(2):383–7.
Leys CM, Hartenbach EM, Hafez GR, Mahvi DM. Screening for occult nodal metastasis in squamous cell carcinoma of the vulva. Int J Gynecol Pathol. 2000;19(3):243–7.
Narayansingh GV, Miller ID, Sharma M, Welch CJ, Sharp L, Parkin DE, et al. The prognostic significance of micrometastases in node-negative squamous cell carcinoma of the vulva. Br J Cancer. 2005;92(2):222–4.
Moss EL, Hirschowitz L, Luesley DM. Skin scar recurrence following removal of a sentinel lymph node containing a solitary micrometastasis of squamous cell vulval cancer. Gynecol Oncol. 2011;121(1):239–40.
TjinAsjoe FM, van Bekkum E, Ewing P, Burger CW, Ansink AC. Sentinel node procedure in vulvar squamous cell carcinoma: a histomorphologic review of 32 cases. The significance of anucleate structures on immunohistochemistry. Int J Gynecol Cancer. 2008;18(5):1032–6.
Johann S, Klaeser B, Krause T, Mueller MD. Comparison of outcome and recurrence-free survival after sentinel lymph node biopsy and lymphadenectomy in vulvar cancer. Gynecol Oncol. 2008;110(3):324–8.
Van der Zee AG, Oonk MH, De Hullu JA, Ansink AC, Vergote I, Verheijen RH, et al. Sentinel node dissection is safe in the treatment of early-stage vulvar cancer. J Clin Oncol. 2008;26(6):884–9.
Programme NBS. Pathology reporting of breast disease. NHS Breast Screening Programme publication; 2005. p. 58.
Le T, Elsugi R, Hopkins L, Faught W, Fung-Kee-Fung M. The definition of optimal inguinal femoral nodal dissection in the management of vulva squamous cell carcinoma. Ann Surg Oncol. 2007;14(7):2128–32.
Walker KF, Day H, Abu J, Nunns D, Williamson K, Duncan T. Do surgical techniques used in groin lymphadenectomy for vulval cancer affect morbidity rates? Int J Gynecol Cancer. 2011;21(8):1495–9.
Horn LC, Liebert UG, Edelmann J, Hockel M, Einenkel J. Adenoid squamous carcinoma (pseudoangiosarcomatous carcinoma) of the vulva: a rare but highly aggressive variant of squamous cell carcinoma-report of a case and review of the literature. Int J Gynecol Pathol. 2008;27(2):288–91.
Lasser A, Cornog JL, Morris JM. Adenoid squamous cell carcinoma of the vulva. Cancer. 1974;33(1):224–7.
Underwood JW, Adcock LL, Okagaki T. Adenosquamous carcinoma of skin appendages (adenoid squamous cell carcinoma, pseudoglandular squamous cell carcinoma, adenocanthoma of sweat gland of Lever) of the vulva: a clinical and ultrastructural study. Cancer. 1978;42(4):1851–8.
Carson LF, Twiggs LB, Okagaki T, Clark BA, Ostrow RS, Faras AJ. Human papillomavirus DNA in adenosquamous carcinoma and squamous cell carcinoma of the vulva. Obstet Gynecol. 1988;72(1):63–7.
Giordano G, D’Adda T, Merisio C, Gnetti L. Vulvar acantholytic squamous carcinoma: a case report with immunohistochemical and molecular study. Int J Gynecol Pathol. 2005;24(3):303–6.
Nappi O, Swanson PE, Wick MR. Pseudovascular adenoid squamous cell carcinoma of the lung: clinicopathologic study of three cases and comparison with true pleuropulmonary angiosarcoma. Hum Pathol. 1994;25(4):373–8.
Parramore B, Hanly M, Yeh KA, McNeely T. Acantholytic variant of squamous cell carcinoma of the breast: a case report. Am Surg. 1999;65(5):467–9.
Papadopoulou E, Tosios KI, Nikitakis N, Papadogeorgakis N, Sklavounou-Andrikopoulou A. Acantholytic squamous cell carcinoma of the gingiva: report of a case and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(6):e67–71.
Horie Y, Kato M. Pseudovascular squamous cell carcinoma of the uterine cervix: a lesion that may simulate an angiosarcoma. Pathol Int. 1999;49(2):170–4.
Japaze H, Van Dinh T, Woodruff JD. Verrucous carcinoma of the vulva: study of 24 cases. Obstet Gynecol. 1982;60(4):462–6.
Brisigotti M, Moreno A, Murcia C, Matias-Guiu X, Prat J. Verrucous carcinoma of the vulva. A clinicopathologic and immunohistochemical study of five cases. Int J Gynecol Pathol. 1989;8(1):1–7.
Degefu S, O’Quinn AG, Lacey CG, Merkel M, Barnard DE. Verrucous carcinoma of the cervix: a report of two cases and literature review. Gynecol Oncol. 1986;25(1):37–47.
Illanes D, Broman J, Meyer B, Kredentser D, McElrath T, Timmins 3rd P. Verrucous carcinoma of the endometrium: case history, pathologic findings, brief review of literature and discussion. Gynecol Oncol. 2006;102(2):375–7.
Fancher TT, Hamzi MH, Macaron SH, Magno WB, Dudrick SJ, Palesty JA. Hybrid verrucous-squamous cell carcinoma of the ovary with synchronous squamous cell carcinoma of the endometrium. Int J Surg Pathol. 2008;16(1):91–5.
Nascimento AF, Granter SR, Cviko A, Yuan L, Hecht JL, Crum CP. Vulvar acanthosis with altered differentiation: a precursor to verrucous carcinoma? Am J Surg Pathol. 2004;28(5):638–43.
Gualco M, Bonin S, Foglia G, Fulcheri E, Odicino F, Prefumo F, et al. Morphologic and biologic studies on ten cases of verrucous carcinoma of the vulva supporting the theory of a discrete clinico-pathologic entity. Int J Gynecol Cancer. 2003;13(3):317–24.
Kondi-Paphitis A, Deligeorgi-Politi H, Liapis A, Plemenou-Frangou M. Human papilloma virus in verrucus carcinoma of the vulva: an immunopathological study of three cases. Eur J Gynaecol Oncol. 1998;19(3):319–20.
Levitan Z, Kaplan AL, Kaufman RH. Advanced squamous cell carcinoma of the vulva after treatment for verrucous carcinoma. A case report. J Reprod Med. 1992;37(10):889–92.
Gadducci A, De Punzio C, Facchini V, Rispoli G, Fioretti P. The therapy of verrucous carcinoma of the vulva. Observations on three cases. Eur J Gynaecol Oncol. 1989;10(4):284–7.
Iwamoto I, Kijima Y, Fujino T, Yoshinaga M, Douchi T. Verrucous carcinoma of the vulva in Turner syndrome. Gynecol Oncol. 2004;92(1):380–3.
Tran TA, Carlson JA. Plasmacytoid squamous cell carcinoma of the vulva. Int J Gynecol Pathol. 2008;27(4):601–5.
Wolber RA, Talerman A, Wilkinson EJ, Clement PB. Vulvar granular cell tumors with pseudocarcinomatous hyperplasia: a comparative analysis with well-differentiated squamous carcinoma. Int J Gynecol Pathol. 1991;10(1):59–66.
Persoons JH, Sutorius FJ, Koopman RJ, Schaafsma MR, van Doorn GA. Vulvar paraneoplastic amyloidosis with the appearance of a vulvar carcinoma. Am J Obstet Gynecol. 1999;180(4):1041–4.
Nuovo GJ, Friedman D, Richart RM. In situ hybridization analysis of human papillomavirus DNA segregation patterns in lesions of the female genital tract. Gynecol Oncol. 1990;36(2):256–62.
Chiasson MA, Ellerbrock TV, Bush TJ, Sun XW, Wright Jr TC. Increased prevalence of vulvovaginal condyloma and vulvar intraepithelial neoplasia in women infected with the human immunodeficiency virus. Obstet Gynecol. 1997;89(5 Pt 1):690–4.
Marshburn PB, Trofatter Jr KF. Recurrent condyloma acuminatum in women over age 40: association with immunosuppression and malignant disease. Am J Obstet Gynecol. 1988;159(2):429–33.
Sonnex C, Strauss S, Gray JJ. Detection of human papillomavirus DNA on the fingers of patients with genital warts. Sex Transm Infect. 1999;75(5):317–9.
Aguilera-Barrantes I, Magro C, Nuovo GJ. Verruca vulgaris of the vulva in children and adults: a nonvenereal type of vulvar wart. Am J Surg Pathol. 2007;31(4):529–35.
Moyal-Barracco M, Leibowitch M, Orth G. Vestibular papillae of the vulva. Lack of evidence for human papillomavirus etiology. Arch Dermatol. 1990;126(12):1594–8.
Crum CP, Fu YS, Levine RU, Richart RM, Townsend DE, Fenoglio CM. Intraepithelial squamous lesions of the vulva: biologic and histologic criteria for the distinction of condylomas from vulvar intraepithelial neoplasia. Am J Obstet Gynecol. 1982;144(1):77–83.
Nucci MR, Genest DR, Tate JE, Sparks CK, Crum CP. Pseudobowenoid change of the vulva: a histologic variant of untreated condylata acuminatum. Mod Pathol. 1996;9(4):375–9.
Harwood CA, Mortimer PS. Acquired vulval lymphangiomata mimicking genital warts. Br J Dermatol. 1993;129(3):334–6.
Brainard JA, Hart WR. Proliferative epidermal lesions associated with anogenital Paget’s disease. Am J Surg Pathol. 2000;24(4):543–52.
Konig A, Wennemuth G, Soyer HP, Hoffmann R, Happle R, Krause W. Vulvar amyloidosis mimicking giant condylomata acuminata in a patient with multiple myeloma. Eur J Dermatol. 1999;9(1):29–31.
Schiera A, Pini M, Pioltelli P, Rossi E, Valente MG, Crippa D. Perianal condyloma-like lesions in multiple myeloma associated amyloidosis. Eur J Dermatol. 2004;14(3):193–5.
Goldsmith PC, Leslie TA, Sams V, Bryceson AD, Allason-Jones E, Dowd PM. Lesions of schistosomiasis mimicking warts on the vulva. BMJ. 1993;307(6903):556–7.
Poggensee G, Kiwelu I, Weger V, Goppner D, Diedrich T, Krantz I, et al. Female genital schistosomiasis of the lower genital tract: prevalence and disease-associated morbidity in northern Tanzania. J Infect Dis. 2000;181(3):1210–3.
Handley J, Hanks E, Armstrong K, Bingham A, Dinsmore W, Swann A, et al. Common association of HPV 2 with anogenital warts in prepubertal children. Pediatr Dermatol. 1997;14(5):339–43.
Domfeh B, Silasi DA, Lindo F, Parkash V. Chronic hypertrophic vulvar herpes simulating neoplasia. Int J Gynecol Pathol. 2012;31(1):33–7.
Mosunjac M, Park J, Wang W, Tadros T, Siddiqui M, Bagirov M, et al. Genital and perianal herpes simplex simulating neoplasia in patients with AIDS. AIDS Patient Care STDS. 2009;23(3):153–8.
Chen W, Koenig C. Vulvar keratoacanthoma: a report of two cases. Int J Gynecol Pathol. 2004;23(3):284–6.
Gilbey S, Moore DH, Look KY, Sutton GP. Vulvar keratoacanthoma. Obstet Gynecol. 1997;89(5 Pt 2):848–50.
Rhatigan RM, Nuss RC. Keratoacanthoma of the vulva. Gynecol Oncol. 1985;21(1):118–23.
Connolly M, Narayan S, Oxley J, de Berker DA. Immunohistochemical staining for the differentiation of subungual keratoacanthoma from subungual squamous cell carcinoma. Clin Exp Dermatol. 2008;33(5):625–8.
Kaabipour E, Haupt HM, Stern JB, Kanetsky PA, Podolski VF, Martin AM. p16 expression in keratoacanthomas and squamous cell carcinomas of the skin: an immunohistochemical study. Arch Pathol Lab Med. 2006;130(1):69–73.
Vasiljevic N, Andersson K, Bjelkenkrantz K, Kjellstrom C, Mansson H, Nilsson E, et al. The Bcl-xL inhibitor of apoptosis is preferentially expressed in cutaneous squamous cell carcinoma compared with that in keratoacanthoma. Int J Cancer. 2009;124(10):2361–6.
Mandrell JC, Santa Cruz D. Keratoacanthoma: hyperplasia, benign neoplasm, or a type of squamous cell carcinoma? Semin Diagn Pathol. 2009;26(3):150–63.
Reich O, Regauer S. Recurrent verruciform xanthoma of the vulva. Int J Gynecol Pathol. 2004;23(1):75–7.
Cumberland L, Dana A, Resh B, Fitzpatrick J, Goldenberg G. Verruciform xanthoma in the setting of cutaneous trauma and chronic inflammation: report of a patient and a brief review of the literature. J Cutan Pathol. 2010;37(8):895–900.
van Beurden M, van der Vange N, de Craen AJ, Tjong AHSP, ten Kate FJ, ter Schegget J, et al. Normal findings in vulvar examination and vulvoscopy. Br J Obstet Gynaecol. 1997;104(3):320–4.
Welch JM, Nayagam M, Parry G, Das R, Campbell M, Whatley J, et al. What is vestibular papillomatosis? A study of its prevalence, aetiology and natural history. Br J Obstet Gynaecol. 1993;100(10):939–42.
Bergeron C, Ferenczy A, Richart RM, Guralnick M. Micropapillomatosis labialis appears unrelated to human papillomavirus. Obstet Gynecol. 1990;76(2):281–6.
Orosz Z, Lehoczky O, Szoke J, Pulay T. Recurrent giant fibroepithelial stromal polyp of the vulva associated with congenital lymphedema. Gynecol Oncol. 2005;98(1):168–71.
Bai H, Cviko A, Granter S, Yuan L, Betensky RA, Crum CP. Immunophenotypic and viral (human papillomavirus) correlates of vulvar seborrheic keratosis. Hum Pathol. 2003;34(6):559–64.
Heller DS, Kuye OO. Recurrent hypertrophy of the labia minora: a hormonally related lesion possibly related to fibroepithelial stromal polyps of the vulva. J Low Genit Tract Dis. 2011;15(1):69–70.
Wani Y, Fujioka Y. A vulvar fibroepithelial stromal polyp appearing in infancy. Am J Dermatopathol. 2009;31(5):465–7.
de Giorgi V, Massi D, Salvini C, Mannone F, Carli P. Pigmented seborrheic keratoses of the vulva clinically mimicking a malignant melanoma: a clinical, dermoscopic-pathologic case study. Clin Exp Dermatol. 2005;30(1):17–9.
Venkatesan A. Pigmented lesions of the vulva. Dermatol Clin. 2010;28(4):795–805.
Li J, Ackerman AB. “Seborrheic keratoses” that contain human papillomavirus are condylomata acuminata. Am J Dermatopathol. 1994;16(4):398–405; discussion 406–8.
Roth LM, Look KY. Inverted follicular keratosis of the vulvar skin: a lesion that can be confused with squamous cell carcinoma. Int J Gynecol Pathol. 2000;19(4):369–73.
Cohen PR, Young Jr AW, Tovell HM. Angiokeratoma of the vulva: diagnosis and review of the literature. Obstet Gynecol Surv. 1989;44(5):339–46.
McNeely TB. Angiokeratoma of the clitoris. Arch Pathol Lab Med. 1992;116(8):880–1.
Yamazaki M, Hiruma M, Irie H, Ishibashi A. Angiokeratoma of the clitoris: a subtype of angiokeratoma vulvae. J Dermatol. 1992;19(9):553–5.
de Giorgi V, Salvini C, Massi D, Raspollini MR, Carli P. Vulvar basal cell carcinoma: retrospective study and review of literature. Gynecol Oncol. 2005;97(1):192–4.
Feakins RM, Lowe DG. Basal cell carcinoma of the vulva: a clinicopathologic study of 45 cases. Int J Gynecol Pathol. 1997;16(4):319–24.
Palladino VS, Duffy JL, Bures GJ. Basal cell carcinoma of the vulva. Cancer. 1969;24(3):460–70.
Wieland U, Ritzkowsky A, Stoltidis M, Weissenborn S, Stark S, Ploner M, et al. Communication: papillomavirus DNA in basal cell carcinomas of immunocompetent patients: an accidental association?TITLE. J Invest Dermatol. 2000;115(1):124–8.
Dudzinski MR, Askin FB, Fowler Jr WC. Giant basal cell carcinoma of the vulva. Obstet Gynecol. 1984;63(3 Suppl):57S–60.
Sworn MJ, Hammond GT, Buchanan R. Metastatic basal cell carcinoma of the vulva. Case report. Br J Obstet Gynaecol. 1979;86(4):332–4.
Kanitakis J, Arbona-Vidal E, Faure M. Extensive pigmented vulvar basal-cell carcinoma presenting as pruritus in an elderly woman. Dermatol Online J. 2011;17(1):8.
Saini R, Sarnoff DS. Basal cell carcinoma of the vulva presenting as unilateral pruritus. J Drugs Dermatol. 2008;7(3):288–90.
Perrone T, Twiggs LB, Adcock LL, Dehner LP. Vulvar basal cell carcinoma: an infrequently metastasizing neoplasm. Int J Gynecol Pathol. 1987;6(2):152–65.
Mizushima J, Ohara K. Basal cell carcinoma of the vulva with lymph node and skin metastasis – report of a case and review of 20 Japanese cases. J Dermatol. 1995;22(1):36–42.
Gleeson NC, Ruffolo EH, Hoffman MS, Cavanagh D. Basal cell carcinoma of the vulva with groin node metastasis. Gynecol Oncol. 1994;53(3):366–8.
Winkelmann SE, Llorens AS. Metastatic basal cell carcinoma of the vulva. Gynecol Oncol. 1990;38(1):138–40.
Hoffman MS, Roberts WS, Ruffolo EH. Basal cell carcinoma of the vulva with inguinal lymph node metastases. Gynecol Oncol. 1988;29(1):113–9.
Cruz-Jimenez PR, Abell MR. Cutaneous basal cell carcinoma of vulva. Cancer. 1975;36(5):1860–8.
Farmer ER, Helwig EB. Metastatic basal cell carcinoma: a clinicopathologic study of seventeen cases. Cancer. 1980;46(4):748–57.
Mulayim N, Foster Silver D, Tolgay Ocal I, Babalola E. Vulvar basal cell carcinoma: two unusual presentations and review of the literature. Gynecol Oncol. 2002;85(3):532–7.
Merino MJ, LiVolsi VA, Schwartz PE, Rudnicki J. Adenoid basal cell carcinoma of the vulva. Int J Gynecol Pathol. 1982;1(3):299–306.
Giuliani M, Di Stefano L, Zoccali G, Angelone E, Leocata P, Mascaretti G. Gorlin syndrome associated with basal cell carcinoma of the vulva: a case report. Eur J Gynaecol Oncol. 2006;27(5):519–22.
Ishizawa T, Mitsuhashi Y, Sugiki H, Hashimoto H, Kondo S. Basal cell carcinoma within vulvar Paget’s disease. Dermatology. 1998;197(4):388–90.
Carr RA, Taibjee S, Sanders DSA. Basaloid skin tumours: basal cell carcinoma. Curr Diagn Pathol. 2007;13:252–72.
Beer TW, Shepherd P, Theaker JM. Ber EP4 and epithelial membrane antigen aid distinction of basal cell, squamous cell and basosquamous carcinomas of the skin. Histopathology. 2000;37(3):218–23.
Beller U, Benedet JL, Creasman WT, Ngan HY, Quinn MA, Maisonneuve P, et al. Carcinoma of the vagina. FIGO 26th annual report on the results of treatment in gynecological cancer. Int J Gynaecol Obstet. 2006;95 Suppl 1:S29–42.
Shah CA, Goff BA, Lowe K, Peters 3rd WA, Li CI. Factors affecting risk of mortality in women with vaginal cancer. Obstet Gynecol. 2009;113(5):1038–45.
Creasman WT, Phillips JL, Menck HR. The National Cancer Data Base report on cancer of the vagina. Cancer. 1998;83(5):1033–40.
Hellman K, Silfversward C, Nilsson B, Hellstrom AC, Frankendal B, Pettersson F. Primary carcinoma of the vagina: factors influencing the age at diagnosis. The Radiumhemmet series 1956–96. Int J Gynecol Cancer. 2004;14(3):491–501.
Eddy GL, Marks Jr RD, Miller 3rd MC, Underwood Jr PB. Primary invasive vaginal carcinoma. Am J Obstet Gynecol. 1991;165(2):292–6; discussion 296–8.
Andersen ES. Primary carcinoma of the vagina: a study of 29 cases. Gynecol Oncol. 1989;33(3):317–20.
Pride GL, Schultz AE, Chuprevich TW, Buchler DA. Primary invasive squamous carcinoma of the vagina. Obstet Gynecol. 1979;53(2):218–25.
Eddy GL, Singh KP, Gansler TS. Superficially invasive carcinoma of the vagina following treatment for cervical cancer: a report of six cases. Gynecol Oncol. 1990;36(3):376–9.
Brinton LA, Nasca PC, Mallin K, Schairer C, Rosenthal J, Rothenberg R, et al. Case–control study of in situ and invasive carcinoma of the vagina. Gynecol Oncol. 1990;38(1):49–54.
Iavazzo C, Vorgias G, Vecchini G, Katsoulis M, Akrivos T. Vaginal carcinoma in a completely prolapsed uterus. A case report. Arch Gynecol Obstet. 2007;275(6):503–5.
Batista TP, Morais JA, Reis TJ, Macedo FI. A rare case of invasive vaginal carcinoma associated with vaginal prolapse. Arch Gynecol Obstet. 2009;280(5):845–8.
Otton GR, Nicklin JL, Dickie GJ, Niedetzky P, Tripcony L, Perrin LC, et al. Early-stage vaginal carcinoma – an analysis of 70 patients. Int J Gynecol Cancer. 2004;14(2):304–10.
Petru E, Luck HJ, Stuart G, Gaffney D, Millan D, Vergote I. Gynecologic Cancer Intergroup (GCIG) proposals for changes of the current FIGO staging system. Eur J Obstet Gynecol Reprod Biol. 2009;143(2):69–74.
Davis KP, Stanhope CR, Garton GR, Atkinson EJ, O’Brien PC. Invasive vaginal carcinoma: analysis of early-stage disease. Gynecol Oncol. 1991;42(2):131–6.
Tjalma WA, Monaghan JM, de Barros Lopes A, Naik R, Nordin AJ, Weyler JJ. The role of surgery in invasive squamous carcinoma of the vagina. Gynecol Oncol. 2001;81(3):360–5.
Hellman K, Lundell M, Silfversward C, Nilsson B, Hellstrom AC, Frankendal B. Clinical and histopathologic factors related to prognosis in primary squamous cell carcinoma of the vagina. Int J Gynecol Cancer. 2006;16(3):1201–11.
Lee YC, Holcomb K, Buhl A, Holden J, Abulafia O. Rapid progression of primary vaginal squamous cell carcinoma in a young HIV-infected woman. Gynecol Oncol. 2000;78(3 Pt 1):380–2.
Miyazaki K, Yamaguchi K, Tohya T, Ohba T, Takatsuki K, Okamura H. Human T-cell leukemia virus type I infection as an oncogenic and prognostic risk factor in cervical and vaginal carcinoma. Obstet Gynecol. 1991;77(1):107–10.
Daling JR, Madeleine MM, Schwartz SM, Shera KA, Carter JJ, McKnight B, et al. A population-based study of squamous cell vaginal cancer: HPV and cofactors. Gynecol Oncol. 2002;84(2):263–70.
van Dam P, Sonnemans H, van Dam PJ, Verkinderen L, Dirix LY. Sentinel node detection in patients with vaginal carcinoma. Gynecol Oncol. 2004;92(1):89–92.
Frumovitz M, Gayed IW, Jhingran A, Euscher ED, Coleman RL, Ramirez PT, et al. Lymphatic mapping and sentinel lymph node detection in women with vaginal cancer. Gynecol Oncol. 2008;108(3):478–81.
Ramzy I, Smout MS, Collins JA. Verrucous carcinoma of the vagina. Am J Clin Pathol. 1976;65(5):644–53.
Jones MJ, Levin HS, Ballard Jr LA. Verrucous squamous cell carcinoma of the vagina; case report. Report of a case and review of the literature. Cleve Clin Q. 1981;48(2):305–13.
Wood WG, Giustini FG, Sohn S, Aranda RR. Verrucous carcinoma of the vagina. South Med J. 1978;71(4):368–71.
Okagaki T, Clark BA, Zachow KR, Twiggs LB, Ostrow RS, Pass F, et al. Presence of human papillomavirus in verrucous carcinoma (Ackerman) of the vagina Immunocytochemical, ultrastructural, and DNA hybridization studies. Arch Pathol Lab Med. 1984;108(7):567–70.
Robertson DI, Maung R, Duggan MA. Verrucous carcinoma of the genital tract: is it a distinct entity? Can J Surg. 1993;36(2):147–51.
Baltzer J, Zander J. Primary squamous cell carcinoma of the neovagina. Gynecol Oncol. 1989;35(1):99–103.
Harder Y, Erni D, Banic A. Squamous cell carcinoma of the penile skin in a neovagina 20 years after male-to-female reassignment. Br J Plast Surg. 2002;55(5):449–51.
Gallup DG, Castle CA, Stock RJ. Recurrent carcinoma in situ of the vagina following split-thickness skin graft vaginoplasty. Gynecol Oncol. 1987;26(1):98–102.
Van Dam PA, Irvine L, Lowe DG, Fisher C, Barton DP, Shepherd JH. Carcinoma in episiotomy scars. Gynecol Oncol. 1992;44(1):96–100.
Rose PG, Stoler MH, Abdul-Karim FW. Papillary squamotransitional cell carcinoma of the vagina. Int J Gynecol Pathol. 1998;17(4):372–5.
Abrenio JK, Chung HI, Pomante R. Verrucous carcinoma arising from an artificial vagina. Obstet Gynecol. 1977;50(1 Suppl):18s–21.
Steiner E, Woernle F, Kuhn W, Beckmann K, Schmidt M, Pilch H, et al. Carcinoma of the neovagina: case report and review of the literature. Gynecol Oncol. 2002;84(1):171–5.
Bobin JY, Zinzindohoue C, Naba T, Isaac S, Mage G. Primary squamous cell carcinoma in a patient with vaginal agenesis. Gynecol Oncol. 1999;74(2):293–7.
Dietl J, Horny HP, Kaiserling E. Lymphoepithelioma-like carcinoma of the vagina: a case report with special reference to the immunophenotype of the tumor cells and tumor-infiltrating lymphoreticular cells. Int J Gynecol Pathol. 1994;13(2):186–9.
Patrelli TS, Silini EM, Berretta R, Thai E, Gizzo S, Bacchi Modena A, et al. Squamotransitional cell carcinoma of the vagina: diagnosis and clinical management: a literature review starting from a rare case report. Pathol Oncol Res. 2011;17(1):149–53.
Koenig C, Turnicky RP, Kankam CF, Tavassoli FA. Papillary squamotransitional cell carcinoma of the cervix: a report of 32 cases. Am J Surg Pathol. 1997;21(8):915–21.
McCluggage WG. Lymphoepithelioma-like carcinoma of the vagina. J Clin Pathol. 2001;54(12):964–5.
Mucitelli DR, Charles EZ, Kraus FT. Vulvovaginal polyps. Histologic appearance, ultrastructure, immunocytochemical characteristics, and clinicopathologic correlations. Int J Gynecol Pathol. 1990;9(1):20–40.
Nucci MR, Young RH, Fletcher CD. Cellular pseudosarcomatous fibroepithelial stromal polyps of the lower female genital tract: an underrecognized lesion often misdiagnosed as sarcoma. Am J Surg Pathol. 2000;24(2):231–40.
Maenpaa J, Soderstrom KO, Salmi T, Ekblad U. Large atypical polyps of the vagina during pregnancy with concomitant human papilloma virus infection. Eur J Obstet Gynecol Reprod Biol. 1988;27(1):65–9.
Hartmann CA, Sperling M, Stein H. So-called fibroepithelial polyps of the vagina exhibiting an unusual but uniform antigen profile characterized by expression of desmin and steroid hormone receptors but no muscle-specific actin or macrophage markers. Am J Clin Pathol. 1990;93(5):604–8.
Stewart CJ, Amanuel B, Brennan BA, Jain S, Rajakaruna R, Wallace S. Superficial cervico-vaginal myofibroblastoma: a report of five cases. Pathology. 2005;37(2):144–8.
Laskin WB, Fetsch JF, Tavassoli FA. Superficial cervicovaginal myofibroblastoma: fourteen cases of a distinctive mesenchymal tumor arising from the specialized subepithelial stroma of the lower female genital tract. Hum Pathol. 2001;32(7):715–25.
McCluggage WG, Young RH. Tubulo-squamous polyp: a report of ten cases of a distinctive hitherto uncharacterized vaginal polyp. Am J Surg Pathol. 2007;31(7):1013–9.
Stewart CJ. Tubulo-squamous vaginal polyp with basaloid epithelial differentiation. Int J Gynecol Pathol. 2009;28(6):563–6.
Chaturvedi A, Padel A. Tubulo-squamous polyp of the vagina with sebaceous glands: novel features in an uncommon recently described entity. Int J Gynecol Pathol. 2010;29(5):494–6.
Tong B, Clarke BA, Ghazarian D. Tubulo-squamous polyp with mucinous differentiation: a unique morphological variant. Int J Gynecol Pathol. 2011;30(5):518–9.
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Brown, L. (2013). Squamous Cell Carcinoma and Basal Cell Carcinoma of the Vulva and Squamous Cell Carcinoma of the Vagina. In: Brown, L. (eds) Pathology of the Vulva and Vagina. Essentials of Diagnostic Gynecological Pathology. Springer, London. https://doi.org/10.1007/978-0-85729-757-0_7
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