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Vulvar Neoplasm
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.
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So 85% of any type of your vulvar neoplasia
would have to be squamous cell.
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Melanomas or adenomas could
also be possible, keep that in mind.
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But however, majority of a time
is squamous cell.
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If it is vulvar neoplasia,
or think about who you are.
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We still have not left the vulva,
the types here would be the same strains
as you do expect with your cervical cancer.
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The highest strains 16, 18, 31, 33.
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HPV negative associate with squamous cell
hyperplasia or lichen sclerosus.
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If you find you patient to be HPV-negative
and the developing squamous cell
cancer of the vulva.
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There might be association as that
I had earlier noted with lichen sclerosus.
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A vulvar neoplasia that is quite
different from squamous cell cancer.
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Welcome to Extramammary Paget’s disease.
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Put all this into perspective forming.
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Mammary Paget’s disease.
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Paget’s disease can be find in three different
places for you on your Boards and Wards.
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Paget’s disease at the bone
called von Recklinghausen's disease
of the bone.
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Then we have Paget’s disease
of the breast, mammary.
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However, where are you right now?
The vulva.
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Therefore, you call this
Extramammary Paget’s disease.
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There are two major types of extramammary:
the bone and the vulva.
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the cell, histological
will appear as being a Paget cell.
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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.
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I also said that there is a possibility
of adenocarcinoma in developing.
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This is an example of that.
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Extramammary Paget’s disease,
these are glandular cells
and it’s an adenocarcinoma.
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Don’t you ever forget that please?
These are malignant cells confined
to the epidermis as supposed to mammary
or breast Paget’s.
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So these are confined to
the epidermis of the vulva.
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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.
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Couple of important , vulvar neoplasia,
make sure that you’ve understood
the topic of vulvar cancer
before moving on to next section.
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Squamous cell cancer, HPV, higher strain,
lichen sclerosus, predisposing factors perhaps.
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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.
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Paget’s disease of vulva upon histologic
examination will show you the following.
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Clusters of large clear tumor cells
within the squamous epithelium.
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Clear.
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These are adenocarcinoma.
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Take a look at the picture on the right.
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you’ll notice on the top right corner
that those appears being glandular,
it is an adenocarcinoma
associated with pruritus.
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Paget’s disease of the vulva.
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Let us now take a look at what’s on
the vulvar intraepithelial neoplasia.
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Do not confuse it with Paget’s.
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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.
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More common.
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Will progress to invasive
squamous carcinoma if untreated.
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Just like what you expect with CIN.
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So, what is this?
What would you call this?
Would you call this insight too?
Or would you call this dysplasia.
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I’m hoping that you would
tell me that this is
good.
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This is going to be your dysplasia.
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So VIN would be increased dysplasia.
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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?
Vulva.