Vulvar cancer pathophysiology

Vulvar cancer Microchapters
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Types

Table 31-1. Histologic Subtypes of Vulvar Cancer

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	Most lesions originate in the labia, primarily the labia majora. Other areas affected are the clitoris, and fourchette, and the local glands unifocal	Eosinophilia Extra large nuclei/bizarre nuclei Inflammation (lymphocytes, plasma cells) Long rete ridges Numerous beeds/blobs of epithelial cells that seem unlikely to be rete ridges
Basal cell carcinoma of vulva	Pearly nodule with telangiectasias	Basaloid cells - similar in appearance to basal cells: Moderate blue/grey cytoplasm. Dark ovoid/ellipsoid nucleus with uniform chromatin Palisading of cells at the edge of the cell nests Artefactual separation of cells (forming the nests) from the underlying stroma - key feature Surrounded by blue (myxoid) stroma - key feature
Vulvar melanoma	Superficial spreading is the most common type Brown/black color, but may include reddish brown or white Hyperkeratotic, diffused borders with no distinct demarcation Irregular and elevated	Presence of intraepidermal lateral spread (most characteristic feature) Dermal invasion Desmoplasia Epidermal hyperplasia Appearance of epithelioid cells with occasional spindle cells