Vulvar cancers in women with vulvar lichen planus: a clinicopathological study.

Regauer, Sigrid; Reich, Olaf; Eberz, Barbara

Regauer, Sigrid; Reich, Olaf; Eberz, Barbara.

Afiliación

Regauer S; Institute of Pathology, Medical University Graz, Graz, Austria. Electronic address: sigrid.regauer@medunigraz.at.
Reich O; Department of Gynecology, Medical University Graz, Graz, Austria.
Eberz B; General Gynecology Practice, Mürzzuschlag, Austria.

J Am Acad Dermatol ; 71(4): 698-707, 2014 Oct.

Article en En | MEDLINE | ID: mdl-24999271

RESUMEN

BACKGROUND: Vulvar squamous cell carcinomas (SCCs) arising in association with vulvar lichen planus (LP) are poorly documented. OBJECTIVES: We sought to present clinicopathological features of 38 patients (median age 61 years, range 39-90 years) with LP-associated vulvar SCCs. METHODS: Evaluated were location of vulvar SCC and metastases at presentation, recurrences, survival, precursor lesions, presence of human papillomavirus DNA, p16ink4a, and p53 expression. RESULTS: In all, 32 solitary (5 pT1a, 20 pT1b, 7 pT2) and 6 multifocal SCCs, located in the vestibulum (n=20) and in nonhair-bearing modified and glycogenated mucosa (n=18), arose in erosive (n=13) and nonerosive (n=25) LP. All SCCs were human papillomavirus DNA and p16ink4a negative. Sixteen of 38 (42%) women had inguinal metastases at presentation. Treatment was surgery with clear margins (36/38) and chemoradiation (2/38). Fourteen of 36 (39%) surgically treated patients developed between 1 and 5 new SCCs in the residual diseased mucosa. Of all recurrences, 68% developed within 12 months via precursors revealing various histologic features including elongated, but also flat rete ridges, basaloid and hypertrophic differentiation with inconsistent p53 expression. Fourteen of 38 (37%) patients died of SCCs. LIMITATIONS: Retrospective study and lack of a standardized treatment protocols are limitations. CONCLUSION: LP-associated SCCs were located in nonhair-bearing vulvar mucosa. Patients had a high rate of inguinal metastases, recurrent vulvar cancers in diseased mucosa, and disease-related death.

Asunto(s)

Carcinoma de Células Escamosas/patología; Liquen Plano/patología; Recurrencia Local de Neoplasia/patología; Neoplasias de la Vulva/patología; Adulto; Anciano; Anciano de 80 o más Años; Biopsia con Aguja; Carcinoma de Células Escamosas/complicaciones; Carcinoma de Células Escamosas/terapia; Quimioradioterapia; Estudios de Cohortes; Terapia Combinada; Supervivencia sin Enfermedad; Femenino; Procedimientos Quirúrgicos Ginecológicos/métodos; Humanos; Inmunohistoquímica; Liquen Plano/complicaciones; Liquen Plano/terapia; Persona de Mediana Edad; Invasividad Neoplásica/patología; Recurrencia Local de Neoplasia/epidemiología; Recurrencia Local de Neoplasia/terapia; Pronóstico; Estudios Retrospectivos; Medición de Riesgo; Análisis de Supervivencia; Enfermedades de la Vulva/complicaciones; Enfermedades de la Vulva/patología; Enfermedades de la Vulva/terapia; Neoplasias de la Vulva/complicaciones; Neoplasias de la Vulva/terapia

Palabras clave

differentiated vulvar intraepithelial neoplasia; human papillomavirusnegative vulvar carcinoma; precursor lesions; vulvar dermatosis; vulvar squamous cell carcinoma

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Vulva / Carcinoma de Células Escamosas / Liquen Plano / Recurrencia Local de Neoplasia Tipo de estudio: Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: J Am Acad Dermatol Año: 2014 Tipo del documento: Article Pais de publicación: Estados Unidos

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