Vulvar Squamous Carcinoma: Basaloid and Warty Patterns


D efinition —Invasive epithelial neoplasm composed of keratinocytes involving the vulva. Comprise tumors associated with classic vulvar intraepithelial neoplasia (VIN).

Clinical Features

Epidemiology

  • Typically affects women in their sixth decade but can be seen in women under 40 who are immunocompromised.

  • Strong association with human papillomavirus (HPV), particularly HPV 16.

  • Usually found associated with classic VIN.

  • Some patients present with no history of vulvar neoplasia.

  • Strong association with smoking.

  • Association with other lesions in the lower genital tract (cervix, vagina).

  • Risk increases with increasing age.

Presentation

  • May be seen in the clinical context of classic VIN symptoms (pruritus, pain, or bleeding).

  • Will often complicate VIN in women aged over 50.

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