vulvar verrucous carcinoma

Introduction

Introduction to vulvar squamous cell carcinoma Vulvar squamous cell carcinoma is a special type of low-grade malignant squamous cell carcinoma, mostly primary tumors that occur in the impregnated parts (such as the mouth, external genitalia, anus and ankle), and can also occur in chronic ulcers, suppurative sweat glands. On the basis of the primary disease such as the sinus drainage, the tumor differentiates well, the malignancy is low, and it slowly develops into a huge mass, and can even block the vulva. Although the tumor is terrible, it is less likely to metastasize to regional lymph nodes. basic knowledge The proportion of illness: 0.0065% Susceptible people: women Mode of infection: non-infectious Complications: vulvitis

Cause

Causes of vulvar squamous cell carcinoma

Primary factor (85%):

Vulvar squamous cell carcinoma is a variant of squamous cell carcinoma that is not associated with HPV infection. Immunohistochemical staining revealed a unique distribution of keratinized proteins AE1 and AE3.

Incentive factor (15%):

The tumor is large, the largest diameter is 10cm, it is grayish red or grayish white. The surface of the naked eye is a huge cauliflower-like tissue, soft and vermicular cancer. The secondary infection is hard, and the mass is more prominent on the surface. The width is a few centimeters or more, and the base of the mass is clearly and neatly separated from the space between them.

Microscopically, it is a well-differentiated squamous epithelium with papillary growth, lack of connective tissue in the center of the nipple, rare nuclear fission, hyperkeratosis and parakeratosis on the surface of the nipple, large, polygonal, blunt or curved nails. Fusion, into the interstitial and oppressive interstitial, is a progressive infiltration, so the bottom and interstitial boundaries of the tumor are clear and flat, no obvious destructive infiltration, keratinized beads are mostly in the deep tumor, nuclear fission is rare, and the interstitial is severe Chronic inflammation, infiltration of numerous lymphocytes and plasma cells, is a characteristic concomitant lesion. The squamous cell carcinoma initially grows in the shape of a wart or scorpion, and finally erodes the deep tissue, causing only regional lymph node metastasis in the most advanced stage.

Sickle cancer type 3:

1. Oral squamous cell carcinoma, also known as oral florid papillomatosis, damages the head like broccoli, pale white, and can invade most of the oral mucosa.

2. Anal genital warts are also called Buschke and Loewenstein giant condyloma acuminatum, most common in the penis and uncut foreskin, showing papillary hyperplasia, and finally invading the urethra, also seen in the female genitals and anus Area.

3. Ankle squamous cell carcinoma, also known as epithelioma cuniculatum, begins to grow outwards, and also grows deep tissue, forming many deep crypts filled with horny and pus. , like a rabbit hole, can finally penetrate the fascia and fascia, and even destroy the tibia, and then invade the skin of the foot.

Prevention

Vulvar cancer prevention

Early detection, early treatment, and good follow-up.

Complication

Vulvar squamous cell carcinoma complications Complications vulvitis

In order to cut the mass, the scope of surgery is large, which can cause the vulva to be reconstructed and the incision to be difficult to heal; the surrounding tissue infection is combined.

Symptom

Vulvar-like cancer symptoms Common symptoms Vulvar swelling vulvar tenderness inguinal lymphadenopathy

Tumor growth is slow, half of the patients have a history of 3 to 10 years, so it is quite large at the time of treatment. The inguinal lymph nodes are swollen due to reactive hyperplasia, and the squamous cell carcinoma is locally devastating, even invading to the bone, genital warts. Cancer is prone to recurrence and less metastasis, regional lymph node metastasis is rare, usually inguinal lymphadenopathy due to reactive hyperplasia.

Examine

Examination of vulvar squamous cell carcinoma

Polymerase chain reaction (PCR) detection, tumor marker detection, and secretion examination.

Histopathological examination: fine needle aspiration cytology or excisional biopsy.

Diagnosis

Diagnosis and diagnosis of vulvar squamous cell carcinoma

diagnosis

According to the lesions, the impregnation site is papillary hyperplasia, combined with histopathology for diagnosis. Because the appearance of squamous cell carcinoma is similar to that of genital warts, it is difficult to distinguish between the two, but the squamous cell carcinoma has interstitial infiltration, so it can be based on pathology. Identification, if found in the metastasis of the inguinal lymph nodes, should be confirmed by fine needle aspiration or biopsy, biopsy to take deep, including interstitial, usually enlarge the lymph nodes for inflammatory hyperplasia.

Differential diagnosis

Condyloma acuminata

Microscopically, the tumor is a variety of papillary lobes, lacking a connective core, like the characteristics of condyloma acuminata. The gross and microscopic appearance of vulvar squamous cell carcinoma is similar to that of Brschke-Loewenstein, which may represent a class of diseases of the same genus.

2. Benign genital warts

A lesion and a sufficient biopsy at the bottom are needed to distinguish between sickle cancer and benign genital warts.

3. Squamous cell carcinoma

Pathological biopsy distinguishes squamous cell carcinoma with a sickle-like growth pattern.

4. Spastic cancer

Sickle cancer should also be distinguished from sputum cancer. The nail tip of sputum cancer forms irregular cancer nest, which is diffuse infiltration, and may have hollow cells, and the DNA of HPV is often positive, while squamous cell carcinoma is changed. Sexual infiltration, the biological behavior of the two is also different.

5. Common

Clinical attention and identification of common warts.

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