Superficial Vulvectomy Research Articles

Paget Disease of the Vulva: One Case Report

Extramammary Paget's disease is a rare neoplasm that usually develops in apocrine gland-bearing areas. Paget's disease of the vulva is a rare form of extramammary Paget's disease affecting postmenopausal women. We report the case of a 39-year-old woman who presented with a vulvar lesion suggestive of Paget's disease involving only the labia majora and minora. Biopsy confirmed the diagnosis of non-invasive Paget's disease. Extension examination was negative. The patient underwent a superficial vulvectomy with healthy margins on histopathology. Postoperative management was uncomplicated.

Lésions vulvaires précancéreuses : mise au point

Vulvar carcinomas represent 4% of all gynaecological cancers with 838 new cases in France in 2018. The precursor lesions of vulvar carcinomas are differentiated vulvar intraepithelial lesion (dVIN) in a context of lichen sclerosus and vulvar high-grade squamous intraepithelial lesion (HSIL) link to human papillomavirus (HPV) infection. Three typical clinical forms of HSIL are described: the Bowenoid papulosis, the Bowen's disease and the confluent VIN. Histopathology cannot differentiate effectively these two types of lesions. P16 and P53 immunostaining are valuable tools to respectively assess HPV infection and divide different types of dVIN. However, P53 immunostaining is still lacking sensibility to detect dVIN. First line therapies are medical treatment excluding the cases with a doubt of invasion. The gold standard treatment for dVIN and vulvar HSIL are respectively topical corticosteroids and imiquimod. Primary prevention for vulvar HSIL and dVIN are respectively HPV vaccination and early treatment of lichen sclerosus. Destructive therapy can be used in case of medical treatment failure such as CO2 laser, cryotherapy, dynamic phototherapy. Surgical indications should be carefully assessed between the risk of recurrence, the spread of the lesions, the aesthetic and functional aspect. Surgical procedures consist in either superficial vulvectomy or radical vulvectomy with or without flap reconstruction. Recurrence rate after surgery is around 20%.

CO2 Laser Total Superficial Vulvectomy: An Outpatient Treatment for Wide Multifocal Vulvar Intraepithelial Neoplasia Grade 3

The ideal treatment of large multifocal vulvar intraepithelial neoplasia grade 3 (VIN 3) in young patients is still debated. The goal is to prevent development of invasive vulvar cancer while preserving normal vulvar anatomy and function. The authors describe the case of a 37-year-old woman affected by a biopsy-proven VIN 3 involving the entire external genitalia. A total superficial vulvectomy was carried out in 2 closer sessions by CO2 laser used in an excisional way. Both procedures were performed in an outpatient setting with the patient under local anesthesia and without suturing stitches or skin flaps. Definitive pathologic analysis confirmed VIN 3 with free margins. No intraoperative and postoperative complications were documented. Functional and anatomic outcomes were optimal, and no relapse occurred after 12 months of follow-up. Use of CO2 laser total superficial vulvectomy shows promise of a safe and adequate treatment in selected young patients with VIN 3 involving the entire external genitalia.

Extensive superficial vulvectomy with primary skin grafting for premalignant

Extensive superficial vulvectomy with primary skin grafting for premalignant

Extensive superficial vulvectomy with primary skin grafting for premalignant lesions

Summary A series of 8 cases of superficial vulvectomy with primary free skin grafting is reported. With careful attention to technique almost 100 per cent take has been achieved. The cosmetic and functional results justify early excision of any chronic lesion of the vulvar epithelium; if more premalignant lesions were treated thus, the incidence of vulvar carcinoma might well be reduced.