Vulvar cancers in women with vulvar lichen planus: A clinicopathological study

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:71

Article

Regauer, Sigrid¹  Reich, Olaf² 

[1] Med Univ Graz, Inst Pathol, A-8036 Graz, Austria

[2] Med Univ Graz, Dept Gynecol, A-8036 Graz, Austria

关键词: differentiated vulvar intraepithelial neoplasia;    human papillomavirus-negative vulvar carcinoma;    precursor lesions;    vulvar dermatosis;    vulvar squamous cell carcinoma;   

DOI  :  10.1016/j.jaad.2014.05.057

来源: Elsevier

【 摘 要 】

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, p16(ink4a), 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 p16(ink4a) 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.

【 授权许可】

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