Demographically, remember, because of the
outside or external nature of these organs
the type of cells of these organs
then are outlined by
will be squamous cells.
So 85% of any type of your vulvar neoplasia
would have to be squamous cell.
Melanomas or adenomas could
also be possible, keep that in mind.
But however, majority of a time
is squamous cell.
If it is vulvar neoplasia,
or think about who you are.
We still have not left the vulva,
the types here would be the same strains
as you do expect with your cervical cancer.
The highest strains 16, 18, 31, 33.
HPV negative associate with squamous cell
hyperplasia or lichen sclerosus.
If you find you patient to be HPV-negative
and the developing squamous cell
cancer of the vulva.
There might be association as that
I had earlier noted with lichen sclerosus.
A vulvar neoplasia that is quite
different from squamous cell cancer.
Welcome to Extramammary Paget’s disease.
Put all this into perspective forming.
Mammary Paget’s disease.
Paget’s disease can be find in three different
places for you on your boards and words.
Paget’s disease at the bone
called von Recklinghausen's disease
of the bone.
Then we have Paget’s disease
of the breast, mammary.
However, where are you right now?
Therefore, you call this
Extramammary Paget’s disease.
There are two major types of extramammary:
the bone and the vulva.
[0:01:55,4] the cell, histological
will appear as being a Paget cell.
So what is Paget’s disease?
What kind of cancer is this?
Earlier, I had mentioned that vulvar disease
if any type of cancer,
85% of time were going
to squamous cell cancer.
I also said that there is a possibility
of adenocarcinoma in developing.
This is an example of that.
Extramammary Paget’s disease,
these are glandular cells
and it’s an adenocarcinoma.
Don’t you ever forget that please?
These are malignant cells confined
to the epidermis as supposed to mammary
or breast Paget’s.
So these are confined to
the epidermis of the vulva.
Other causes of vulva neoplasia
include the following:
Malignant melanoma, rare but could occur in
peak incidence with sixth a little bit later
in age of you female, sixth or seventh decade.
Couple of important , vulvar neoplasia,
make sure that you’ve understood
the topic of vulvar cancer
before moving on to next section.
Squamous cell cancer, HPV, higher strain,
lichen sclerosus, predisposing factors perhaps.
Next, Extramammary Paget’s disease,
what kind of cancer in the vulva,
adeno, the malignant melanoma
as where is it may be look for this
perhaps in a female in her 60s or 70s.
Paget’s disease of vulva upon histologic
examination will show you the following.
Clusters of large clear tumor cells
within the squamous epithelium.
These are adenocarcinoma.
Take a look at the picture on the right.
you’ll notice on the top right corner
that those appears being glandular,
it is an adenocarcinoma
associated with pruritus.
Paget’s disease of the vulva.
Let us now take a look at what’s on
the vulvar intraepithelial neoplasia.
Do not confuse it with Paget’s.
So here, with the fact that well the same
type of progression that you’ll expect with
cervical intraepithelial neoplasia
could be found here with VIN as well.
Will progress to invasive
squamous carcinoma if untreated.
Just like what you expect with CIN.
So, what is this?
What would you call this?
Would you call this insight too?
Or would you call this dysplasia.
I’m hoping that you would
tell me that this is
This is going to be your dysplasia.
So VIN would be increased dysplasia.
In other words, this ordered growth
and in some point at time,
when you go from VIN 1, 2 and 3,
you will then rupture the membrane
and go on to invasis squamous cancer of
what organ right now?