Mehmet H. ERGENELİ, Tolga ERGİN, Esra KUŞÇU, Hulusi B. ZEYNELOĞLU, Beyhan DEMİRHAN, Mithat ERDOĞAN

VULVAR INTRAEPITHELIAL NEOPLASIA COEXISTING WITH NONNEOPLASTIC EPITHELIAL DISORDERS OF THE VULVA

Objective: To assess the frequency of vulvar intraepithelial neoplasia (VIN) adjacent to the nonneoplastic epithelial disorders (NNEDs) of the vulva.Methods: Seventy eight patients with the diagnosis of vulvar NNEDs were reviewed "retrospectively in respect to their coexistence with VINs, treatment options and follow-up reports.Results: The rate of VIN coexisting with vulvar NNEDs was 7.7% (6 of 78 patients). One of these (17%) had been associated with cervical intraepithelial neoplasia1. The age of those with vulvar NNEDs were similar to the age of those with VIN and vulvar NNEDs. Treatment options for VINs were skinning vulvectomy or laser therapy. None of the patients had recurrence during the mean follow-up period of 15.5 months.Conclusion: VINs, which have a substantial risk of progressing to carcinoma, may not infrequently coexist with NNEDs of the vulva. Therefore, NNEDs of the vulva must be followed carefully with frequent colposcopic examinations and biopsies if new lesions are recognized.Key Words: Nonneoplastic epithelial disorders of the vulva, vulvar intraepithelial neoplasia

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I. Friedrich EG Jr. International Society for the Study of Vulvar Disease: new nomenclature for vulvar disease. Report of the Committee on Terminology. Obstet Gynecol 1976;47:122-124.
Ridley CM, Frankman O, Jones IS, et al. new nomenclature for vulvar disease: International Sociey for the Study of Vulvar Disease. Hum Pathol 1989;20:495-496.
Elchalal U, Gilead L, Vardy D, Ben-shachar I, Anteby S, Schenker J. Treatment of vulvar lichen sclerosis in the elderly: an update. Obstet Gynecol Survey 1995;50:155-162.
Lavery HA. Vulvar dystrophies.: new approaches. Clin Obstet Gynecol 1984; 11:155-169.
Chafe W, Richards A, Morgan L, Wilkinson E. Unrecognized invasive carcinoma in vulvar intraepithelial neoplasia (Vin). Gynecol Oncol 1988;31:154-165.
Jones R, Rowan D. Vulvar intraepithelial neoplasia III: a clinical study of the outcome in 113 cases with relation to the later development of invasive vulvar carcinoma. Obstet Gynecol 1994,84:741-745.
Crum CP, Liskow A, Petras P, et al. Vulvar intraepithelial neoplasia (severe atypia and carcinoma in situ): A clinicopathologic analysis of 41 cases. Cancer 1984;54:1429-1434.
Lininger RA, Tavassoli FA. The pathology of vulvar neoplasia. Curr Opin Obstet Gynecol 1996,8:63-68.
Kaufman R. Distinguished professor series: intraepithelial neoplasia of the vulva. Gynecol Oncol 1995;56:8-21.
Messing M, Gallup D. Carcinoma of the vulva in young women. Obstet Gynecol 1995;86:51-54.
McAdams AJ, Kistner RW. The relationship of chronic vulvar disease, leukoplakia and carcinoma in situ to carcinoma of the vulva. Cancer 1958; 11- 740-743.
Charles D. Vulvar dystrophy. J Obstet Gynaecol BR Commonw 1963;70:712-716.
Jeffcoat THA, Woodcock /IS. Premalignant conditions of the vulva, with particular reference to chronic epithelial dystrophies. Br Med J 1961;2:127-131.
Friedrich EG, Burch K, BahrJP. The vulvar clinic: An eight-year appraisal. Am J Obstet Gynecol 1979; 135:1036-1040.
Micheletti L, Borgno G, Barbero M, et al. Cellular atypia in vulvar dystrophies. J Reprod Med 1988;33:539-541.
Barbero M, Michelletti L, Borgno G, Cavanna L, Preti M, Ghiringhello B. Vulvar dystrophies in young and premenopausal women. J Reprod Med 1988;33:555-558.