Vulval and Vaginal Pathology

Question 1

What is VIN?

Answer 1

Vulval Intraepithelial Neoplasia

Question 2

Who does VIN affect?

Answer 2

Young women - multifocal, recurrent and presistent thus posing treatment problems
Elderly - likely to become squamous carcinoma

Question 3

What is VIN associated with?

Answer 3

HPV 16 and 18

also can present as a mixed picture with CIN

Question 4

Is VIN more or less predictable that CIN?

Answer 4

less

Question 5

What is vulval invasive squamous carcinoma?

Answer 5

a cancer affecting the vulva (commonly older women) that does not always develop from VIN - can come from normal epithelium also

Question 6

Where will vulval carcinoma spread?

Answer 6

to the inguinal nodes

Question 7

What is the treatment of vulval carcinoma?

Answer 7

radical vulvectomy with lymphadenectomy

Question 8

What is the survival rates (5 years) if positive or negative nodes? - vulval carcinoma

Answer 8

negative nodes = 90%

positive nodes = < 60%

Question 9

What is paget’s disease of the vulva

Answer 9

this is a crusting disease caused by tumour cells in the epidermis

Question 10

will pagets become invasive?

Answer 10

rarely - tumour arises from the sweat glands in the skin

Question 11

What infective pathologies can affect the vulva?

Answer 11

HPV warts (6 and 11)
Candida (esp diabetics)
Bartholin’s glands abscess (blocked ducts)

Question 12

What is VaIN?

Answer 12

this is vaginal intraepithelial neoplasia and may be associated with CIN and VIN

Question 13

Who will present with VaIN?

Answer 13

disease of the elderly - much less common than the vulval and cervical counterparts