Clinicopathologic analysis of 19 cases of usual type vulvar intraepithelial neoplasia

Abstract

To reclassify the patients with former diagnosis of vulvar intraepithelial neoplasia (VIN)II, VINII-III, VINIII, Bowen disease and Bowenoid papulosis according to the 2004 modified terminology of International Society for the Study of Vulvar Disease (ISSVD) and evaluate the effects of surgical treatment. According to the 2004 modified terminology of ISSVD, a retrospective review of the histological slides of 19 cases, who diagnosed as VINII, VINII-III, VINIII, Bowen disease and Bowenoid papulosis treated in Peking Union Medical College Hospital from 1999 to 2006, were performed to reclassify by pathologist and the clinicopathologic data were also analyzed. According to the 2004 modified terminology of ISSVD, all 19 cases were reclassified as usual type VIN and were belonged to the subtype of warty type except one, the only Bowen disease patient whose one of focuses belonged to the subtype of basaloid type and the other focus belonged to the subtype of warty type. The primary cure rate of extended local excision was 89% (17/19). There were two cases recurred during follow-up period, and were cured by second surgical treatment and the focuses of recurrence site were still diagnosed as warty type VIN. The patients with former diagnosis of VINII, VINII-III, VINIII, Bowen disease and Bowenoid papulosis are basically reclassified as usual type VIN (warty type) according to the 2004 modified terminology of ISSVD. The results showed that the diagnosis of VIN could be simplified by new terminology. The surgical excision is the good choice and combined cytologic and human papillomavirus (HPV) test during follow up is also important for patients of VIN.