1/68. Human papillomavirus types 16 and 39 in a vulval carcinoma occurring in a woman with Hailey-Hailey disease.A woman with Hailey-Hailey disease, suffering from carcinoma of the vulva, was examined by histology and for the presence of human papillomavirus (HPV) DNA by polymerase chain reaction (PCR) and in situ hybridization. Our diagnosis by histological examination revealed the vulval carcinoma to be a squamous cell carcinoma (SCC), adjacent to lesions of Hailey-Hailey disease and severe dysplasia/carcinoma in situ [vulval intraepithelial neoplasia (VIN) III]. The PCR with consensus primers for the L1 region (L1-PCR) successfully amplified HPV DNA using total DNA extracted from formalin-fixed and paraffin-embedded tissue specimens. Restriction fragment length polymorphism analysis and sequencing of L1-PCR products revealed HPV types 16 and 39. HPV 16-specific primers for the E6 region identified HPV 16 DNA. in situ hybridization analysis with biotinylated HPV 16 and 39 dna probes revealed the presence of the HPV 39 genome in the nuclei of the tumour cells in the SCC. These results indicate that HPV 16 and 39 are associated with lesions in vulval carcinoma. Regarding the patient's susceptibility to infection in the case of Hailey-Hailey disease, there is a possibility that HPV was inoculated into the lesions of Hailey-Hailey disease and induced those of VIN III and SCC.- - - - - - - - - - ranking = 1keywords = intraepithelial neoplasia, intraepithelial, neoplasia (Clic here for more details about this article) |
2/68. Cervical adenoid cystic carcinoma coexisting with multiple human papillomavirus-associated genital lesions. A common etiology?Adenoid cystic carcinoma of the uterine cervix is a rare tumor with unknown etiology. We report a case of adenoid cystic carcinoma occurring in a young woman, associated with multiple human papillomavirus (HPV)-related lesions including condyloma acuminata, vulvar intraepithelial neoplasm, cervical intraepithelial neoplasm and invasive basaloid squamous cell carcinoma. While adenoid cystic carcinoma has previously been found to coexist with squamous cell carcinoma or cervical intraepithelial neoplasia, its association with such a variety of HPV-related lesions in our case has not been previously reported, and raises the speculation that HPV may also be the causative factor for adenoid cystic carcinoma. However, in situ DNA hybridization and polymerase chain reaction in our current study failed to demonstrate the existence of HPV DNA in adenoid cystic carcinoma.- - - - - - - - - - ranking = 2.795143493151keywords = intraepithelial neoplasia, cervical intraepithelial, intraepithelial, cervical intraepithelial neoplasia, neoplasia (Clic here for more details about this article) |
3/68. Extension of extramammary Paget disease of the vulva to the cervix.Extramammary Paget disease of the vulva was found in association with vulval adenocarcinoma in an elderly woman who also had a uterine prolapse. The characteristic histological appearances of extramammary Paget disease were masked by striking reactive changes in the squamous epithelium. Primary excision of both the intraepithelial and invasive disease appeared complete. However, a subsequent hysterectomy with repair of the prolapse revealed extramammary Paget disease in the upper vaginal mucosa and cervix, a finding which is very rarely described. Pathogenesis and diagnosis of extramammary Paget disease is discussed, with differential diagnosis and reference to immunohistochemical methods.- - - - - - - - - - ranking = 0.34829123557142keywords = intraepithelial (Clic here for more details about this article) |
4/68. Squamous cell carcinoma arising in Hailey-Hailey disease of the vulva.A 61-year-old woman, who was known to have Hailey-Hailey disease, presented with increasing vulval soreness. biopsy showed vulval intraepithelial neoplasia (VIN) 3 and subsequent histology from a vulvectomy specimen showed extensive VIN with early invasive squamous cell carcinoma. This may be another example of chronic inflammation of the vulval area leading to the development of squamous cell carcinoma. However, in this case, chronic human papillomavirus may also have played a part, leading to VIN and reactivation of the Hailey-Hailey disease. We can find no previous reports of squamous cell carcinoma developing in the setting of Hailey-Hailey disease.- - - - - - - - - - ranking = 1keywords = intraepithelial neoplasia, intraepithelial, neoplasia (Clic here for more details about this article) |
5/68. Radical excision of multifocal anal intraepithelial neoplasia: report of a case.PURPOSE: The aim of this study was to describe the technique of radical excision of multifocal anal intraepithelial neoplasia and discuss controversial issues surrounding the management of this condition. METHOD: We describe the case of a 31-year-old female with previous vulval warts, vulval squamous carcinoma, and recent immunosuppression who had widespread anal intraepithelial neoplasia excised, and the resulting defect was split-skin grafted, including the anal canal. RESULTS: Excision and split-skin grafting was successful in removing the disease and left a satisfactory cosmetic and functional result. CONCLUSION: Diffuse, high-grade, anal intraepithelial neoplasia is rare. Excision of these lesions remains controversial but may be the best option.- - - - - - - - - - ranking = 7keywords = intraepithelial neoplasia, intraepithelial, neoplasia (Clic here for more details about this article) |
6/68. Self-administered topical imiquimod treatment of vulvar intraepithelial neoplasia. A report of four cases.BACKGROUND: Vulvar intraepithelial neoplasia (VIN) generally can be classified into viral and nonviral etiologies. The histopathologic diagnosis is often separable into basaloid and warty types. A large percentage of VIN lesions have been shown to harbor human papillomavirus (HPV), principally type 16. Imiquimod, an immune response modifier, has been shown to be safe and effective for the treatment of external and perianal genital warts caused by HPV. CASES: Four cases occurred of clinical and histopathologically diagnosed viral VIN 3. An imiquimod treatment protocol, previously used in a study of this drug for the treatment of external genital warts, was followed. Imiquimod 5% cream was patient applied three times per week until all lesions cleared, for a maximum of 16 weeks. CONCLUSION: Imiquimod may be an effective treatment modality for viral VIN 3 in the future.- - - - - - - - - - ranking = 5keywords = intraepithelial neoplasia, intraepithelial, neoplasia (Clic here for more details about this article) |
7/68. Immunohistochemical localization of telomerase hTERT protein and analysis of clonality in multifocal vulvar intraepithelial neoplasia.Vulvar intraepithelial neoplasias (VINs) are potentially premalignant lesions of the squamous mucosa. The immunohistochemical distribution of the catalytic protein subunit of telomerase (hTERT) and the patterns of x chromosome inactivation were investigated as markers of neoplasia in samples from a patient with multifocal and diffuse VIN. hTERT nuclear staining in VIN correlated with squamous maturation and the degree of nuclear atypia. Normal mucosa revealed faint nuclear staining of parabasal cells and lower intermediate layer squamous cells. Monoclonal composition was demonstrated in 0 of 3 samples of VIN1, 2 of 3 samples of VIN2, and 13 of 13 samples of VIN3. The patterns of x chromosome inactivation indicated intramucosal extension and multifocal origin of individual lesions. Five samples of histologically normal vulvar squamous epithelium revealed a random pattern of x chromosome inactivation, consistent with polyclonal composition. All 19 samples from 9 lesions contained human papillomavirus (HPV)-16 sequences. Neither mutations in the p53 tumor suppressor gene or K-ras oncogenes nor loss of heterozygosity at 7 chromosomal loci were detected in any of the 19 samples of VIN. These results demonstrate that HPV-associated VIN may result from multifocal and diffuse 2-dimensional intraepithelial expansion of an immortalized monoclonal cell population.- - - - - - - - - - ranking = 5.3559858650746keywords = intraepithelial neoplasia, intraepithelial, neoplasia (Clic here for more details about this article) |
8/68. Vulvar keratinizing squamous cell carcinoma in a 26-year-old woman.A 26-year-old Hispanic woman complaining of "itching" and "herpetic lesions" on the vulva for 9 months was seen at a university hospital. On physical examination, multiple vulvar masses were noted. Biopsies taken from these lesions showed invasive keratinizing squamous cell carcinoma. The vulvectomy specimen revealed 4 tumor masses, the largest located on the mons pubis. Although the incidence of vulvar intraepithelial neoplasia has increased in recent years, only very few cases of invasive carcinoma have been reported in young women. The tumors that occur at a younger age characteristically have basaloid or warty histology, in contrast to those occurring in older women, which usually are well-differentiated keratinizing carcinomas. We believe this is an unusual case of vulvar squamous cell carcinoma. In addition to our patient's young age, her tumor had a histologic profile usually found in lesions of an elderly woman. The tumor was negative for human papillomavirus by polymerase chain reaction analysis and was positive for p53 by immunohistochemistry.- - - - - - - - - - ranking = 1keywords = intraepithelial neoplasia, intraepithelial, neoplasia (Clic here for more details about this article) |
9/68. Invasive condylomatous vulvar carcinoma associated with multifocal low genital tract neoplasia. A case report.Squamous cell carcinoma is a morphologically heterogenous neoplasm of specific histologic entities involved in human papillomavirus infection. The condylomatous types of squamous cell vulvar carcinoma, caused by HPV-16, most often manifest as exophytic papillary tumors mimicking condylomas.- - - - - - - - - - ranking = 0.030778518012881keywords = neoplasia (Clic here for more details about this article) |
10/68. vulvodynia: an indicator or even an early symptom of vulvar cancer.vulvodynia is a symptom of chronic, painful vulvar discomfort of multicausal origin. Vulvar cancer is an underestimated cause of vulvodynia. Even early stages of vulvar neoplasia can lead to aching lesions. Three cases of vulvar carcinoma eliciting persistent pain have been diagnosed within a 2-year period. In 2 of our case studies, women had antecedent periods of vulvar pruritus of long duration (5 and 20 years, respectively). We conclude that early histologic examination of all visible vulvar lesions is necessary to exclude the presence of malignant vulvar neoplasia.- - - - - - - - - - ranking = 0.01538925900644keywords = neoplasia (Clic here for more details about this article) |
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