Vulvar cancer pathophysiology: Difference between revisions
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==Overview== | ==Overview== | ||
==Pathogenesis of vulvar cancer== | |||
* [[HPV|Human papillomaviruses]] subtypes 16 and 18 (High risk) play an essential role in the pathogenesis of vulvar cancer. Once [[HPV]] enters an epithelial cell, the virus begins to make the proteins it encodes. Two of the proteins made by high-risk HPVs (E6 and E7) interfere with cell functions that normally prevent excessive growth, helping the cell to grow in an uncontrolled manner and to avoid cell death. Many times these infected cells are recognized by the immune system and eliminated. Sometimes, however, these infected cells are not destroyed, and a persistent infection results. As the persistently infected cells continue to grow, they may develop mutations in cellular genes that promote even more abnormal cell growth, leading to the formation of an area of precancerous cells and, ultimately, a cancerous tumor. | |||
* Vulvar carcinoma has its origins at the it can involve the outer squamous cells, the inner glandular cells, or both. The precursor lesion is [[dysplasia]]: [[ vulvarintraepithelial neoplasia]] (VIN), which can subsequently become invasive cancer. This process can be quite slow. Longitudinal studies have shown that in patients with untreated in situ vulvar cancer, 30% to 70% will develop invasive carcinoma over a period of 10 to 12 years. However, in about 10% of patients, lesions can progress from in situ to invasive in a period of less than 1 year. As it becomes invasive, the tumor breaks through the basement membrane and invades the vulvar stroma. Extension of the tumor in the cervix may ultimately manifest as ulceration, exophytic tumor, or extensive infiltration of underlying tissue, including the bladder or rectum. | |||
== Types == | == Types == | ||
Revision as of 15:58, 30 September 2015
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Overview
Pathogenesis of vulvar cancer
- Human papillomaviruses subtypes 16 and 18 (High risk) play an essential role in the pathogenesis of vulvar cancer. Once HPV enters an epithelial cell, the virus begins to make the proteins it encodes. Two of the proteins made by high-risk HPVs (E6 and E7) interfere with cell functions that normally prevent excessive growth, helping the cell to grow in an uncontrolled manner and to avoid cell death. Many times these infected cells are recognized by the immune system and eliminated. Sometimes, however, these infected cells are not destroyed, and a persistent infection results. As the persistently infected cells continue to grow, they may develop mutations in cellular genes that promote even more abnormal cell growth, leading to the formation of an area of precancerous cells and, ultimately, a cancerous tumor.
- Vulvar carcinoma has its origins at the it can involve the outer squamous cells, the inner glandular cells, or both. The precursor lesion is dysplasia: vulvarintraepithelial neoplasia (VIN), which can subsequently become invasive cancer. This process can be quite slow. Longitudinal studies have shown that in patients with untreated in situ vulvar cancer, 30% to 70% will develop invasive carcinoma over a period of 10 to 12 years. However, in about 10% of patients, lesions can progress from in situ to invasive in a period of less than 1 year. As it becomes invasive, the tumor breaks through the basement membrane and invades the vulvar stroma. Extension of the tumor in the cervix may ultimately manifest as ulceration, exophytic tumor, or extensive infiltration of underlying tissue, including the bladder or rectum.
Types
Table 31-1. Histologic Subtypes of Vulvar Cancer[1][2][3][4]
1. Vulvar carcinomas
- Squamous cell carcinoma
- Basal cell carcinoma
- Vulvar Paget disease
- Adenocarcinoma
- Transitional cell carcinoma
- Verrucous carcinoma
- Merkel cell tumors
- Verrucous carcinoma
2. Vulvar malignant melanoma
3. Vulvar sarcoma
- Leiomyosarcoma
- Malignant fibrous histiocytoma
- Epithelial sarcoma
| Vulvar carcinomas Subtype | Features on Gross Pathology | Features on Histopathological Microscopic Analysis |
| Squamous cell carcinoma of vulva |
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| Basal cell carcinoma of vulva |
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| Vulvar melanoma |
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References
- ↑ Hoffman, Barbara (2012). Williams gynecology. New York: McGraw-Hill Medical. ISBN 9780071716727.
- ↑ Malignant melanoma. Libre pathology. http://librepathology.org/wiki/index.php/Malignant_melanoma. URL Accessed on September 30, 2015
- ↑ Basal cell carcinoma . Libre pathology. http://librepathology.org/wiki/index.php/Basal_cell_carcinoma. URL Accessed on September 30, 2015
- ↑ Squamous cell carcinoma. Libre pathology. http://librepathology.org/wiki/index.php/Squamous_cell_carcinoma. URL Accessed on September 30, 2015