Description of two cases of advanced vulvar cancer in patients with different profiles and pathology results, and outline of the treatment strategies for each of them.
The first case describes a 62 year-old woman admitted with ketoacidosis who had not attended a doctor in years. She was admitted to the intensive care unit, and Gynaecology staff were asked to assess a vulvar lesion. On assessment, a lesion was found covering the right labia minora and majora, with presence of tissue necrosis and stench, and extending to the distal third of the urethra and vagina.
The second case describes an 89 year-old woman undergoing annual checks for scleroatrophic lichen for the last three years who attended before her check because the lesion had grown. On inspection, the lesion covered the left labia minora and majora and lower third of vagina, but the urethra was not affected.
The same entity presents two different onsets, with varying degrees of differentiation. In the first case the biopsy was found to be positive to human papilloma virus protein. This type of lesion is more frequently found in younger patients. The second type of onset usually derives from previous lesions such as lichen and is more frequently found in older patients. Both patients have only recently been diagnosed, therefore therapeutic management cannot be described.
Vulvar cancer is an infrequent disease. It is usually diagnosed at early stages and treatment includes surgical resection. It is important to advise patients to attend in case of dubious findings in the vulvar region, in order to achieve early diagnosis.
1. Di Paola G. Cáncer de vulva. Encicopedia medicoquirúrgica. E- 520-A- 10. 2. Belardi MG, Di Paola GR, Vigh S, Gómez Rueda N. Neolplasia de la vulva y sus enfermedades precursoras. Monografias de dermatolog, 1993; 6, nº4: 25 3. Gómez Rueda N, Garcia A, Belardi M, di Paola GR, Epithelial alterations adjacent to invasive squamous carcinoma of the vulva. J. Repr. Med, 1992; 34: 221.
2. Belardi MG, Di Paola GR, Vigh S, Gómez Rueda N. Neolplasia de la vulva y sus enfermedades precursoras. Monografias de dermatolog, 1993; 6, nº4: 25