Basal cell carcinoma of the vulva
Introduction
Introduction to vulvar basal cell carcinoma Vulvar basal cell carcinoma (basalcellcarcinomaofvulva) is an uncommon vulvar malignancy with low malignancy. Most of the lesions are locally infiltrated, easy to relapse, slow growth, rarely metastasized, accounting for 2% to 3% of vulvar malignant tumors. The common site is the labia majora, which can also appear in the labia minora, clitoris and labia. basic knowledge Sickness ratio: 0.0001% Susceptible people: women Mode of infection: non-infectious Complications: malignant melanoma, breast cancer, cervical cancer, skin cancer
Cause
Causes of vulvar basal cell carcinoma
(1) Causes of the disease
Vulvar basal cell carcinoma is a malignant tumor derived from vulvar epithelial basal cells. The true cause of vulvar basal cell carcinoma is unknown. It has been reported that it may be related to local radiotherapy, but other parts of basal cell carcinoma, such as basal cell carcinoma of the head and face may be associated with daylight. Related, but this still does not fully explain the cause of all vulvar basal cell carcinoma.
(two) pathogenesis
The tumor is located in the labia majora, which develops slowly and rarely invades the lymph nodes. There are three basic types, and the three types can exist alone or in combination.
1. Nodular ulcer type: manifested as a substantial nodule; deep ulcer formed in the middle, and the edge bulge is a ridge-like bulge, which is an erosive ulcer.
2. Flat type: the lesion is superficial, flat, rough surface waxy, papules, erythema, with melanin or reddish color, hard texture.
3. Polyp type: The surface of the polypoid is complete.
Microscopically, the tumor tissue grows from the basal layer of the epidermis and extends to the dermis or stroma. The outline is like a rod, or irregularly distributed. The outer line of the cell nest is a layer of cells arranged in a fence. Rod-shaped, dark-colored, its long axis is arranged in a fence, which is equivalent to the basal cells of the epidermis. In the central part of the cell, the nucleus is oval, and there are not many cytoplasm; some contain more pigments and are dark, tissue There are many kinds of structures, some are nested, and there are horned beads in the nest; there are also glandular cavity in the nest; some cell nests are connected with the epidermis, some are close to the shape of the hair follicle, no matter which one has A characteristic is that there is always a layer of basal cells arranged in a grid at the edge of the tumor tissue, and some tumor tissues are squeezed into a cable strip by surrounding fibrous tissue, which is called a sclerosis type. This cancer has a local infiltration behavior, but generally does not Metastasis is mild, such as squamous cell carcinoma in the cancer, which is called basal squamous cell carcinoma. The degree of malignancy is determined by the degree of differentiation of this part of squamous cell carcinoma. Histologically basal cell carcinoma Should be associated with skin sweat gland cancer and hair cancer In addition, sweat adenomas have two layers of cell alignment, and hair cancer has a structure of primordial hair follicles, both of which have no rim-like basal cell layer characteristics, and should be differentiated from basal-like cell carcinoma. Lighter, histologically, there are knockout cells that test positive for HPV DNA, which are lacking in basal cell carcinoma.
Prevention
Vulvar basal cell carcinoma prevention
For elderly women with small lumps of the labia majora should seek medical treatment in a timely manner, if necessary, biopsy, after the diagnosis should pay attention to the physical examination to exclude other malignant tumors, should be followed up.
Complication
Vulvar basal cell carcinoma complications Complications malignant melanoma breast cancer cervical cancer skin cancer
About 20% of vulvar basal cell carcinomas are associated with other cancers, such as vulvar squamous cell carcinoma, malignant melanoma, breast cancer, cervical cancer or skin cancer.
Symptom
Vulvar basal cell cancer symptoms Common symptoms Itching polyp nodules
Symptom
The lesions of vulvar basal cell carcinoma are mostly single and occasionally multiple. The disease has a long history and no symptoms at first. Since then, itching and burning are the main symptoms. There may be pain or bleeding, ulceration and ulceration. There is a bloody odor secretion, which may have a history of basal cell carcinoma in other parts of the body.
2. Signs
Often expressed as a small lesion, located in the labia majora, can also appear in the labia minora, clitoris and labial ligaments, early gray lesions, almost translucent, located under the thinned epithelium, small nodules often <2cm in diameter, The three basic types are nodular ulcer type, flat type, and polyp type.
Examine
Examination of vulvar basal cell carcinoma
Blood routine examination, secretion examination, and tumor marker examination.
Histopathological examination.
Diagnosis
Diagnosis and diagnosis of vulvar basal cell carcinoma
diagnosis
According to the clinical manifestations and examination findings, the diagnosis is generally no difficulty, but it needs to be histopathologically examined to confirm the diagnosis. Because the growth of vulvar basal cell carcinoma is slow and rarely invades the lymph nodes, it often takes a long time from symptom on diagnosis to treatment. It has been reported that the average is 6.6 years. If only one lesion is seen in the genital area, the skin of the whole body should be examined for basal cell carcinoma.
Differential diagnosis
1. Identification of undifferentiated squamous cell carcinoma of the vulva: usually the lesion develops faster, the medical history is shorter, and regional lymph node metastasis is prone to occur.
2. Identification of vulvar melanoma with vulva: if there is pigmentation, it should be differentiated from vulvar melanoma, but it is often difficult to identify. The diagnosis requires pathological examination. The vulvar melanoma has a history and malignant process, and it develops rapidly after malignant transformation. Regional lymph node metastasis is prone to occur.
3. Identification with vestibular large adenocarcinoma.
4. Identification of undifferentiated squamous cell carcinoma: Undifferentiated squamous cell carcinoma usually develops rapidly, has a short history, and is prone to regional lymphatic metastasis.
5. Identification with papilloma.
6. Identification of vulvar tuberculosis: easy to form ulcers, cheese-like secretions at the bottom of the ulcer, history of tuberculosis, pathological biopsy can confirm.
