1
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Güral Z, Yücel S, Agaoglu F. Bartholin's gland adenoid cystic carcinoma: Report of three cases and the review of literature. Indian J Cancer 2024; 61:346-349. [PMID: 39016258 DOI: 10.4103/ijc.ijc_359_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/30/2021] [Indexed: 07/18/2024]
Abstract
The adenoid cystic carcinoma (ACC) of Bartholin's gland is a very rare tumor that usually grows aggressively due to perineural invasion. Although there is no guideline for the treatment due to the small number of patients, the primary treatment is considered as surgery. Adjuvant radiotherapy has also been shown to be beneficial. Three cases, which were histopathologically confirmed as ACC of Bartholin's gland and received adjuvant radiotherapy treatment, were presented in this study.
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Affiliation(s)
- Zeynep Güral
- Department of Radiation Oncology, Acibadem Atakent Hospital, İstanbul, Turkey
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2
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Wang L, Chen G, Jiang J, Liu G, Tuo YL, Li X, Zhang W. Vulvar Hidradenoma Papilliferum. Int J Gen Med 2024; 17:663-667. [PMID: 38435116 PMCID: PMC10906731 DOI: 10.2147/ijgm.s449102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
Aim This study examines the clinical and pathological characteristics, immune profile, histological occurrence, diagnosis, and differential diagnosis of vulvar hidradenoma papilliferum. Methods An analysis was conducted on clinical data, histological patterns, and immunohistochemical findings from 45 cases of vulvar hidradenoma papilliferum, and relevant published articles were reviewed. Simultaneously, high-risk HPV typing was performed on these 45 cases. Results The 45 cases of vulvar hidradenoma papilliferum displayed tumor sizes ranging from 0.3 to 2.0 cm and were observed to be pink or red in appearance. Vacuolated cytoplasm, large abnormal nuclei, distinct nucleoli, and scattered eosinophilic luminal secretions were observed in the glands. Positive staining for CK7 and progesterone receptor (PR) with focal mammaglobin and GCDFP-15 expression was found through immunohistochemistry. CK20 staining was noted as negative. Conclusion Hidradenoma papilliferum is a rare benign tumor that originates in secretory glands. The diagnosis of this condition is aided by gross and immunohistochemical results, and differentiation from other conditions is necessary.
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Affiliation(s)
- Lixin Wang
- Department of Pathology, Jinhu County People’s Hospital, Huaian City, People’s Republic of China
| | - Gang Chen
- Department of Pathology, Jinhu County People’s Hospital, Huaian City, People’s Republic of China
| | - Jingui Jiang
- Department of Pathology, Jinhu County People’s Hospital, Huaian City, People’s Republic of China
| | - Guoyan Liu
- Department of Gynecology, Jinhu County People’s Hospital, Huaian City, People’s Republic of China
| | - Ying-Lan Tuo
- Department of Pathology, Dazhou People’s Hospital, Dazhou City, People’s Republic of China
| | - Xiaohong Li
- Department of Pathology, First People’s Hospital of Zigong City, Zigong City, People’s Republic of China
| | - Weishan Zhang
- Department of Pathology, Suining People’s Hospital, Suining City, People’s Republic of China
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3
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Sağnıç S, Ay SS, Tuncer HA, Doğan S, Şimşek T. Hidradenoma papilliferum of the perineum; a rare tumour in a rare location. J OBSTET GYNAECOL 2023; 43:2186781. [PMID: 36912189 DOI: 10.1080/01443615.2023.2186781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Affiliation(s)
- Saliha Sağnıç
- Department of Gynecology Obstetrics, Division of Gynecologic Oncology, Akdeniz University, Antalya, Turkey
| | - Sinan Serdar Ay
- Department of Gynecology Obstetrics, Division of Gynecologic Oncology, Akdeniz University, Antalya, Turkey
| | - Hasan Aykut Tuncer
- Department of Gynecology Obstetrics, Division of Gynecologic Oncology, Akdeniz University, Antalya, Turkey
| | - Selen Doğan
- Department of Gynecology Obstetrics, Division of Gynecologic Oncology, Akdeniz University, Antalya, Turkey
| | - Tayup Şimşek
- Department of Gynecology Obstetrics, Division of Gynecologic Oncology, Akdeniz University, Antalya, Turkey
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4
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Bencherifi Y, El Abbassi I, Amghar A, Ennachit M, Benhessou M, Elkarroumi M. Paget disease of de Vulva: About a rare case and a literature review. Int J Surg Case Rep 2023; 111:108870. [PMID: 37793235 PMCID: PMC10550582 DOI: 10.1016/j.ijscr.2023.108870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/06/2023] Open
Abstract
INTRODUCTION Paget disease of de Vulva (PDV) is a rare neoplastic intraepithelial pathology. In the majority of cases, neoplastic proliferation remains intraepithelial and the prognosis is favorable. The standard treatment for Paget disease is surgical excision. We report the observation of a patient with extensive and recurrent vulvar Paget's disease which we treated with surgery. PRESENTATION OF CASE A 39-year-old single woman presented with itchy heterogeneous erythematous vulvar lesions suggestive of Paget disease. A biopsy confirmed the diagnosis of non-invasive Paget disease. Surgical excision of the lesions was realized, with the anatomopathological examination confirming the diagnosis. DISCUSSION MPV is often diagnosed late due to the absence of specific symptoms in its initial phase. Clinically, it manifests as an erythematous lesion or eczema. Immunohistochemistry plays a crucial role in the diagnosis of VPM, helping to distinguish the disease from other vulvar conditions. Vulvar MPV has recently been subdivided into two subtypes: type 1, which concerns primary vulvar lesions, and type 2, which concerns associated primary non-cutaneous adenocarcinomatous proliferations or pagetoid intraepithelial urothelial carcinomas. Surgery is considered the gold standard treatment for MPV. CONCLUSION PDV is a complex disease requiring appropriate diagnosis and management, with surgery as the main treatment, but other less invasive therapeutic options may be considered on a case-by-case basis. Prognostic factors play an important role in the choice of treatment and disease progression.
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Affiliation(s)
- Y Bencherifi
- Department of Gynecology and Obstetrics, University Hospital Center Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Imane El Abbassi
- Department of Gynecology and Obstetrics, University Hospital Center Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
| | - A Amghar
- Department of Gynecology and Obstetrics, University Hospital Center Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - M Ennachit
- Department of Gynecology and Obstetrics, University Hospital Center Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - M Benhessou
- Department of Gynecology and Obstetrics, University Hospital Center Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - M Elkarroumi
- Department of Gynecology and Obstetrics, University Hospital Center Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
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5
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Bravo-Taxa M, Taxa-Rojas L. [Concurrence of primary extramammary Paget's disease of the vulva and vulval intra-epithelial neoplasia: A case report]. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2023; 56:196-200. [PMID: 37419559 DOI: 10.1016/j.patol.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 07/09/2023]
Abstract
Extramammary Paget's disease and intraepithelial vulvar neoplasia are common lesions in the vulva. However, their simultaneous occurrence is extremely rare. We present the case of a 77year-old woman who presented with a 16month history of pruritus and a rash in the vulvar region with gradually increasing bleeding. She underwent a right hemivulvectomy and a left simple vulvectomy. The histopathology revealed a coexistence of both Paget's disease and high grade intraepithelial vulvar neoplasia.
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Affiliation(s)
- Mercedes Bravo-Taxa
- Laboratorio Oncológico Taxa, Lima, Perú; Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú.
| | - Luis Taxa-Rojas
- Laboratorio Oncológico Taxa, Lima, Perú; Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú; Universidad de San Martín de Porres, Lima, Perú
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6
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Regmi A, Zelman B, Mudaliar KM, Speiser JJ. Solitary Vulvar Syringoma With Deep Extension; Potential for Misdiagnosis as the Microcystic Adnexal Carcinoma (MAC). Am J Dermatopathol 2023; 45:180-184. [PMID: 36729101 DOI: 10.1097/dad.0000000000002364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/06/2022] [Indexed: 02/03/2023]
Abstract
ABSTRACT A 43-year-old woman presented with a palpable, pruritic, minimally painful right vulvar lesion. Physical examination revealed approximately 2.0-cm tender nodule at 70' clock in the right labia majora. Histological sections of the excision specimen showed an unremarkable epidermis with large, well-circumscribed dermal proliferation with extension to the reticular dermis. Within this proliferation are small solid and ductal structures relatively evenly distributed in the sclerotic stroma. The epithelial elements consisted of monomorphous cuboidal cells and assumed round, oval, curvilinear, or have other peculiar geometric shapes, including "comma-like" or "tadpole"-like configurations. The tumor cells were positive for CEA, EMA, and estrogen receptor and negative for progesterone receptor. The clinical presentation and the deep extension of the tumor were similar to the microcystic adnexal carcinoma. Although a syringoma generally presents with multiple lesions and usually involves the superficial dermis, a syringoma with deep extension was favored based on the lack of follicular differentiation, atypia, mitoses, and perineural invasion. Microcystic adnexal carcinoma and syringoma have a morphologic overlap and are misdiagnosed in 30% of the cases. Thus, it is exceptionally important for pathologists to be aware of and be able to distinguish these entities. To the best of our knowledge, this is the first case of a solitary, painful vulvar syringoma with deep extension.
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Affiliation(s)
- Aayushma Regmi
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, IL; and
| | - Brandon Zelman
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, IL; and
| | | | - Jodi J Speiser
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, IL; and
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7
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Li YX, Gudi M, Yan Z. Primary Eccrine Porocarcinoma of the Breast: A Case Report and Review of Literature. Case Rep Oncol Med 2022; 2022:4042298. [PMID: 35685061 PMCID: PMC9173910 DOI: 10.1155/2022/4042298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/04/2022] [Accepted: 05/06/2022] [Indexed: 11/18/2022] Open
Abstract
Eccrine porocarcinoma (EPC) is a rare cutaneous neoplasm, with less than 500 reported cases worldwide since it was first described in 1963. EPC tends to affect the elderly and most commonly affects the head and neck. The mainstay of EPC treatment is surgery, with lymphadenectomy in the case of nodal involvement or presence of unfavourable characteristics. No evidence exists to guide the use of adjuvant chemotherapy or radiation. EPC is prone to misdiagnosis given its multiple clinical and histopathological mimics, especially in uncommon sites of presentation such as the breast. Herein, we report the case of a 59-year-old woman who presented with a left breast skin lump. The biopsied specimen revealed an infiltrative carcinoma involving the dermis and epidermis with positive IHC staining for P63 and CK5/6 and negative staining for ER, PR, and HER2. The tumour was resected and diagnosed as EPC with atypical features as overlapping characteristics of squamous cell carcinoma (SCC) were detected on histopathological analysis. In our case, a simple mastectomy with broad margins and axillary lymph node dissection with adjuvant radiotherapy to a dose of 60 Gy failed to achieve loco-regional control with nodal recurrence occurring 4 months postsurgery-a testament to the aggressive course of this rare malignancy.
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Affiliation(s)
| | - Mihir Gudi
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
| | - Zhiyan Yan
- Breast Department, KK Women's and Children's Hospital, Singapore
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8
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Uesugi‐Uchida S, Oyama N, Yoshida Y, Hasegawa M. Efficacy of topical adapalene monotherapy for symptomatic relief in a long‐standing vulvar syringoma: A case report and literature review with treatment update. JOURNAL OF CUTANEOUS IMMUNOLOGY AND ALLERGY 2021. [DOI: 10.1002/cia2.12216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Saori Uesugi‐Uchida
- Department of Dermatology Division of Medical Sciences University of Fukui Fukui Japan
| | - Noritaka Oyama
- Department of Dermatology Division of Medical Sciences University of Fukui Fukui Japan
| | - Yoshio Yoshida
- Department of Gynecology Division of Medical Sciences University of Fukui Fukui Japan
| | - Minoru Hasegawa
- Department of Dermatology Division of Medical Sciences University of Fukui Fukui Japan
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9
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Sally R, Shaw KS, Pomeranz MK. Benign "lumps and bumps" of the vulva: A review. Int J Womens Dermatol 2021; 7:383-390. [PMID: 34621949 PMCID: PMC8484947 DOI: 10.1016/j.ijwd.2021.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 04/18/2021] [Accepted: 04/22/2021] [Indexed: 11/24/2022] Open
Abstract
Vulvar dermatology represents a challenge for many providers. Given that the vulva is both a gynecologic and dermatologic organ, patients with cutaneous lesions involving the vulva may present to primary care, gynecology, or dermatology. Particularly within dermatology, the vulva remains understudied, which can lead to anxiety among providers regarding appropriate next steps in the diagnosis and management of vulvar lesions. Thus, the purpose of this review is to highlight commonly encountered anatomic variants and benign neoplasms of the vulva, distinguish them from key pathologic mimickers, and provide guidance to practicing dermatologists on what may constitute normal vulvar variations.
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Affiliation(s)
- Rachel Sally
- The Ronald O. Perelman Department of Dermatology, NYU School of Medicine, New York, New York
| | - Katharina S Shaw
- The Ronald O. Perelman Department of Dermatology, NYU School of Medicine, New York, New York
| | - Miriam Keltz Pomeranz
- The Ronald O. Perelman Department of Dermatology, NYU School of Medicine, New York, New York
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10
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Kenny B, Zhao Y, Banerjee T, Osmond A. Pigmented apocrine hamartoma: A distinct and uncommon pigmented lesion with dendritic melanocytes and appraisal of terminology. J Cutan Pathol 2021; 49:172-175. [PMID: 34590346 DOI: 10.1111/cup.14139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/18/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022]
Abstract
A 20-year-old female presented to a gynecologist with an irregular, darkly pigmented, vulvar lesion. Histopathologic sections of a biopsy specimen showed cystically dilated glands with apical snouts, pigmented secretion, and numerous dendritic melanocytes. The lesion was diagnosed as a pigmented apocrine hamartoma of the vulva. We report the fifth case of this uncommonly encountered entity and discuss the conflicting terminology in the literature of this rare, pigmented lesion.
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Affiliation(s)
- Bret Kenny
- Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Yayuan Zhao
- Department of Pathology and Laboratory Medicine, Saskatchewan Health Authority, Saskatoon, Canada
| | - Tamalina Banerjee
- Department of Pathology and Laboratory Medicine, Saskatchewan Health Authority, Saskatoon, Canada
| | - Allison Osmond
- Department of Pathology and Laboratory Medicine, Saskatchewan Health Authority, Saskatoon, Canada
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11
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Bueno D, Caniego-Casas T, Sánchez-Martínez MC, Saavedra-Serrano C, Palacios J, Pérez-Mies B. Vulvar Pilomatrix Carcinoma: Morphologic and Molecular Features. Int J Gynecol Pathol 2021; 40:482-486. [PMID: 33252403 DOI: 10.1097/pgp.0000000000000726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Pilomatrix carcinoma (PC) is a rare malignant variant of pilomatrixoma, a skin adnexal tumor originating from hair matrix cells. It is most often located in the head, neck region, upper back and upper extremities. PC has a locally aggressive behavior but metastasis only occur in 10% of cases. Mutations in CTNNB1, the encoding gene of beta-catenin, have been found in both pilomatrixoma and PC, but other molecular alterations are unknown. The authors present a case of PC in the clitoris, the third known reported case located on the external genitalia. The tumor followed an unusual clinical course with the development of multiple metastases. Next-generation sequencing analysis of the tumor identified, in addition to a characteristic CTNNB1 mutation, pathogenic mutations in PTEN, PIK3CA, and ARID1A, which could explain the aggressive course of the disease. The diagnostic criteria of PC and the differential diagnoses of this unusual tumor in the genital area are discussed.
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12
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Algeri P, Rodella R, Manfredini C, Algeri M. An Unusual Case of Genital Lesion: A Vulvar Syringoma. J Family Reprod Health 2021; 15:70-73. [PMID: 34429739 PMCID: PMC8346743 DOI: 10.18502/jfrh.v15i1.6080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective: Syringoma is a benign adnexal neoplasm of sweat gland, usually presenting as extra-genital lesions, while vulvar localization is rare. Moreover, syringoma is an uncommon vulvar neoplasms. Case report: A 44-year-old woman with previous diagnosis of duodenal gastrointestinal stromal tumour, underwent a local surgical excision for an isolated, painful, vulvar lesion. The specimen was submitted for histological examination. A vulvar syringoma was diagnosed. Conclusion: We describe this case according on its rarity and atypical presentation as well; therefore, vulvar neoplasms encompass many differential diagnoses, among which the incidence rate of syringoma is very low. Although its rarity, syringoma should be included among the differential diagnosis for vulvar neoplasm.
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Affiliation(s)
- Paola Algeri
- Department of Obstetrics and Gynaecology, Bolognini Hospital, ASST Bergamo est, Seriate, Bergamo, Italy
| | - Rosita Rodella
- Department of Pathological Anatomy, Bolognini Hospital, ASST Bergamo est, Seriate, Bergamo, Italy
| | - Cinzia Manfredini
- Department of Pathological Anatomy, Bolognini Hospital, ASST Bergamo est, Seriate, Bergamo, Italy
| | - Maurizio Algeri
- Department of Obstetrics and Gynaecology, Locatelli Hospital, ASST Bergamo est, Piario, Bergamo, Italy
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13
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Birge O, Bakır MS, Karadag C, Eldarova Z, Simsek T. Hidradenoma papilliferum of the hymen: a case report. J Med Case Rep 2021; 15:162. [PMID: 33845900 PMCID: PMC8042849 DOI: 10.1186/s13256-021-02786-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 03/12/2021] [Indexed: 11/21/2022] Open
Abstract
Background Hidradenoma papilliferum is a rare benign neoplasm arising from apocrine glands. It occurs commonly on the anogenital region of middle-aged women. It usually presents as a slow growing, solitary asymptomatic, skin colored or red nodule less than 1 cm in diameter. Case presentation The case is a 38-year-old, white woman who presented with a painful nodule occurring within a month in the himenal region of the posterior vaginal introitus. The nodule was excisied and the histology revealed a hidradenoma papilliferum. The diagnosis and treatment of hidradenoma papilliferum is possible with surgical removal and histopathological evaluation of nodules. Conclusion When an adult woman presents with a noduler lesion in the anogenital area, sexually transmitted diseases and other benign and malignant vulvar lesions, as well as malignant transformation is very rare but,should be kept in mind; however because it has been reported and long-term clinical follow-up is suggested
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Affiliation(s)
- Ozer Birge
- Department of Gynaecology and Obstetrics, Nyala Sudan Turkey Training and Research Hospital, Nyala, Darfur, Sudan. .,Department of Gynaecology and Obstetrics, Akdeniz University Hospital, Antalya, Turkey.
| | - Mehmet Sait Bakır
- Department of Gynaecology and Obstetrics, Akdeniz University Hospital, Antalya, Turkey.,Division of Gynecologic Oncology, Department of Gynecology Obstetrics, Akdeiz University, Antalya, Turkey
| | - Ceyda Karadag
- Department of Gynaecology and Obstetrics, Akdeniz University Hospital, Antalya, Turkey.,Division of Gynecologic Oncology, Department of Gynecology Obstetrics, Akdeiz University, Antalya, Turkey
| | - Zivar Eldarova
- Department of Gynaecology and Obstetrics, Akdeniz University Hospital, Antalya, Turkey.,Division of Gynecologic Oncology, Department of Gynecology Obstetrics, Akdeiz University, Antalya, Turkey
| | - Tayup Simsek
- Department of Gynaecology and Obstetrics, Akdeniz University Hospital, Antalya, Turkey.,Division of Gynecologic Oncology, Department of Gynecology Obstetrics, Akdeiz University, Antalya, Turkey
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14
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Raef HS, Elmariah SB. Vulvar Pruritus: A Review of Clinical Associations, Pathophysiology and Therapeutic Management. Front Med (Lausanne) 2021; 8:649402. [PMID: 33898486 PMCID: PMC8058221 DOI: 10.3389/fmed.2021.649402] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/12/2021] [Indexed: 01/08/2023] Open
Abstract
Vulvar pruritus is an unpleasant sensation and frequent symptom associated with many dermatologic conditions, including infectious, inflammatory and neoplastic dermatoses affecting the female genitalia. It can lead to serious impairment of quality of life, impacting sexual function, relationships, sleep and self-esteem. In this review, common conditions associated with vulvar itch are discussed including atopic and contact dermatitis, lichen sclerosus, psoriasis and infectious vulvovaginitis. We review the potential physiologic, environmental and infectious factors that contribute to the development of vulvar itch and emphasize the importance of addressing their complex interplay when managing this disruptive and challenging symptom.
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Affiliation(s)
- Haya S Raef
- Tufts University School of Medicine, Boston, MA, United States.,Massachusetts General Hospital, Boston, MA, United States
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15
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Atypical Non-neoplastic Changes in Anogenital Mammary-like Glands Accompanying Invasive Squamous Cell Carcinoma. Int J Gynecol Pathol 2021; 40:180-184. [PMID: 32897970 DOI: 10.1097/pgp.0000000000000691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Long regarded as ectopic or supernumerary breast tissue, anogenital mammary-like glands (AGMLG) are now considered a normal constituent of the anogenital area. AGMLG are presumed to be the origin for various benign and malignant lesions. Changes in AGMLG compatible with usual ductal hyperplasia and atypical ductal hyperplasia considered as precursor lesions and its presence in specimens can be explained by their role in the pathogenesis of primary extramammary Paget disease. In this report, we presented four cases of invasive squamous cell carcinoma accompanied by non-neoplastic atypical changes in ductal portions of AGMLG compatible with atypical ductal hyperplasia in breast adjacent to the carcinoma. This is a reactive phenomenon similar to that seen in apocrine/eccrine glands adjacent to squamous cell carcinoma. In a limited biopsy specimen, these areas should not be mistaken for adenocarcinoma.
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16
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Joehlin-Price AS, Mully TW. Review of 189 Consecutive Female Genital Skin and Mucosal Biopsies Submitted to an Academic Dermatopathology Practice. Am J Clin Pathol 2021; 155:418-427. [PMID: 32915210 DOI: 10.1093/ajcp/aqaa135] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To describe consecutive vulvar biopsy cases and to create an educational template for pathology trainees and practicing pathologists. METHODS We reviewed 189 consecutive biopsies from the female genital area skin and mucosa. We classified them based on etiologies and examined limited clinical information. RESULTS We classified diagnoses as squamous intraepithelial neoplasia (21.5%), melanocytic neoplasia (17.9%), lichenoid dermatoses (15.9%), nonlichenoid dermatoses (11.3%), infectious (6.2%), reparative (4.6%), or miscellaneous (22.6%). The miscellaneous diagnoses included common entities (polyps and cysts) and rarer entities (calcinosis cutis, adnexal neoplasms, or basal cell carcinoma) and nonspecific descriptive diagnoses. Clinicians most often included the actual diagnosis in their differential for melanocytic lesions (83%) and least often for inflammatory lesions (32%). However, some cases included a clinical description without a differential diagnosis (14%) or no helpful clinical information (4%). The distribution of whether correct diagnoses were included in the clinical differential was similar between submitting physicians and midlevel providers. CONCLUSIONS Understanding squamous and melanocytic pathology and the various lichenoid and other inflammatory diagnoses is critical for signing out female genital tract skin pathology. The cases examined in this report can serve as an educational template for trainees and practicing pathologists.
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Affiliation(s)
- Amy S Joehlin-Price
- Department of Pathology, Cleveland Clinic, and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
| | - Thaddeus W Mully
- UCSF Dermatopathology and Oral Pathology Service, San Francisco, CA
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17
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Lisner T, Plantier F. [Diagnosis of pigmented lesions of the vulva]. Ann Pathol 2021; 42:79-84. [PMID: 33568264 DOI: 10.1016/j.annpat.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 01/15/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Tomo Lisner
- Service d'anatomopathologie, groupe hospitalier de l'Est Francilien, 2-4, cours de la Gondoire, 77600 Jossigny, France.
| | - Françoise Plantier
- Service d'anatomopathologie, hôpital Cochin, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France
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Moulonguet I, Plantier F. [Extra Mammary Paget disease]. Ann Pathol 2021; 42:68-75. [PMID: 33436149 DOI: 10.1016/j.annpat.2020.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/09/2020] [Accepted: 11/16/2020] [Indexed: 11/30/2022]
Abstract
Extramammary Paget's disease is a rare malignancy. The underlying cause of VPD remains not well understood. We provide an overview of the histopathology of vulvar Paget's disease, with or without invasion.
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Williams EA, Montesion M, Sharaf R, Corines J, Patel PJ, Gillespie BJ, Pavlick DC, Sokol ES, Alexander BM, Williams KJ, Elvin JA, Ross JS, Ramkissoon SH, Hemmerich AC, Tse JY, Mochel MC. CYLD-mutant cylindroma-like basaloid carcinoma of the anus: a genetically and morphologically distinct class of HPV-related anal carcinoma. Mod Pathol 2020; 33:2614-2625. [PMID: 32461623 PMCID: PMC7685972 DOI: 10.1038/s41379-020-0584-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/17/2020] [Accepted: 05/18/2020] [Indexed: 11/12/2022]
Abstract
Rare reports of anal carcinoma (AC) describe histologic resemblance to cutaneous cylindroma, but mutations in the tumor suppressor CYLD, the gene responsible for familial and sporadic cylindromas, have not been systematically investigated in AC. Here, we investigate CYLD-mutant AC, focusing on molecular correlates of distinct histopathology. Comprehensive genomic profiling (hybrid-capture-based DNA sequencing) was performed on 574 ACs, of which 75 unique cases (13%) harbored a CYLD mutation. Clinical data, pathology reports, and histopathology were reviewed for each CYLD-mutant case. The spectrum of CYLD mutations included truncating (n = 50; 67%), homozygous deletion (n = 10; 13%), missense (n = 16; 21%), and splice-site (n = 3; 4%) events. Compared with CYLD-wildtype AC (n = 499), CYLD-mutant ACs were significantly enriched for females (88% vs. 67%, p = 0.0001), slightly younger (median age 59 vs. 61 years, p = 0.047), and included near-universal detection of high-risk HPV sequences (97% vs. 88%, p = 0.014), predominantly HPV16 (96%). The CYLD-mutant cohort also showed significantly lower tumor mutational burden (TMB; median 2.6 vs. 5.2 mut/Mb, p < 0.00001) and less frequent alterations in PIK3CA (13% vs. 31%, p = 0.0015). On histopathologic examination, 73% of CYLD-mutant AC (55/75 cases) showed a striking cylindroma-like histomorphology, composed of aggregates of basaloid cells surrounded by thickened basement membranes and containing characteristic hyaline globules, while only 8% of CYLD-wildtype tumors (n = 34/409) contained cylindroma-like hyaline globules (p < 0.0001). CYLD-mutant carcinomas with cylindroma-like histomorphology (n = 55) showed significantly lower TMB compared with CYLD-mutant cases showing basaloid histology without the distinctive hyaline globules (n = 14) (median 1.7 vs. 4.4 mut/Mb, p = 0.0058). Only five CYLD-mutant cases (7%) showed nonbasaloid conventional squamous cell carcinoma histology (median TMB = 5.2 mut/Mb), and a single CYLD-mutant case showed transitional cell carcinoma-like histology. Within our cohort of ACs, CYLD mutations characterize a surprisingly large subset (13%), with distinct clinical and genomic features and, predominantly, a striking cylindroma-like histopathology, representing a genotype-phenotype correlation which may assist in classification of AC.
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Affiliation(s)
- Erik A Williams
- Foundation Medicine, Inc., 150 Second Street, Cambridge, MA, 02141, USA.
| | - Meagan Montesion
- Foundation Medicine, Inc., 150 Second Street, Cambridge, MA, 02141, USA
| | - Radwa Sharaf
- Foundation Medicine, Inc., 150 Second Street, Cambridge, MA, 02141, USA
| | - James Corines
- Department of Pathology, State University of New York Upstate Medical University, 766 Irving Avenue, Syracuse, NY, 13210, USA
| | - Parth J Patel
- Department of Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, 19140, USA
| | | | - Dean C Pavlick
- Foundation Medicine, Inc., 150 Second Street, Cambridge, MA, 02141, USA
| | - Ethan S Sokol
- Foundation Medicine, Inc., 150 Second Street, Cambridge, MA, 02141, USA
| | - Brian M Alexander
- Foundation Medicine, Inc., 150 Second Street, Cambridge, MA, 02141, USA
| | - Kevin Jon Williams
- Department of Physiology and Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, 19140, USA
| | - Julia A Elvin
- Foundation Medicine, Inc., 150 Second Street, Cambridge, MA, 02141, USA
| | - Jeffrey S Ross
- Foundation Medicine, Inc., 150 Second Street, Cambridge, MA, 02141, USA
- Department of Pathology, State University of New York Upstate Medical University, 766 Irving Avenue, Syracuse, NY, 13210, USA
| | - Shakti H Ramkissoon
- Foundation Medicine, Inc., 150 Second Street, Cambridge, MA, 02141, USA
- Wake Forest Comprehensive Cancer Center and Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | | | - Julie Y Tse
- Foundation Medicine, Inc., 150 Second Street, Cambridge, MA, 02141, USA
- Department of Pathology & Laboratory Medicine, Tufts University School of Medicine, 145 Harrison Ave, Boston, MA, 02111, USA
| | - Mark C Mochel
- Departments of Pathology and Dermatology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
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Invasive Vulval Paget's disease treated with primary radiotherapy: A rare case report and literature review. Gynecol Oncol Rep 2020; 34:100674. [PMID: 33251315 PMCID: PMC7683267 DOI: 10.1016/j.gore.2020.100674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/05/2020] [Accepted: 11/08/2020] [Indexed: 12/30/2022] Open
Abstract
A rare case of Vulval Paget’s Disease (VPD) treated with primary Radiotherapy(RT) Till date only 14 cases of VPD have been treated with primary RT in literature. This case is probably the 15th case to be reported. Invasive VPD in perimenopausal age group is very rare as was in this case. Role of radiotherapy for treating invasive VPD is still not established in literature.
Extramammary Vulval Paget’s Disease (VPD) is rare neoplasm of post-menopausal women. In relatively young perimenopausal patients, it can cause both diagnostic dilemma and therapeutic challenges. Majority of VPD is of non-invasive variety. Among invasive Paget’s disease, only 20% cases show invasion more than 1 mm. The present report describes a unique case of an invasive extra-mammary VPD with depth of invasion more than 4 mm presenting at a relatively young perimenopausal lady. Only 14 cases of VPD has been treated with primary radiotherapy in literature till date. We report this case to be the 15th case where radiotherapy was solely used to treat an invasive VPD.
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Tosti G, Salvini C, Barisani A, Grazi R, Pirola S, Cantisani C, Vaccari S, Madnani N. Vulval hidradenoma papilliferum: a clinical and dermoscopic study. Clin Exp Dermatol 2020; 45:1035-1039. [PMID: 32356582 DOI: 10.1111/ced.14254] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 12/16/2022]
Abstract
Hidradenoma papilliferum (HP) is a rare, slow-growing, benign adnexal tumour with apocrine differentiation. It usually affects the anogenital region in adult women and is clinically polymorphous, mimicking other benign or malignant neoformations. The dermoscopic features of vulval HP have not been reported yet. We report the clinical and dermoscopic features in a case series of histopathologically proven vulval HPs. Dermoscopy may be a useful tool for the diagnosis of vulval HP. To our knowledge, our paper represents the first report of dermoscopic findings in a series of vulval HPs in a multiracial population.
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Affiliation(s)
- G Tosti
- Melanoma Division, IRCCS, European Institute of Oncology, Milan, Italy
| | - C Salvini
- Unit of Dermatology, USL Toscana Centro-Prato Hospital, Prato, Italy
| | - A Barisani
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - R Grazi
- Vita-Salute San Raffaele University, Milan, Italy
| | - S Pirola
- Pathology Division, IRCCS, European Institute of Oncology, Milan, Italy
| | - C Cantisani
- Dermatology Complex Operative Unit, Policlinico Umberto I, Sapienza Medical School of Rome, Rome, Italy
| | - S Vaccari
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - N Madnani
- PD Hinduja National Hospital and Sir HN Reliance Foundation Hospital, Mumbai, India
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Furlan K, Rohra P, Mir F, Gattuso P. Non-human-papillomavirus-related malignancies of the vulva: A clinicopathological study. J Cutan Pathol 2020; 47:917-922. [PMID: 32511773 DOI: 10.1111/cup.13768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 05/22/2020] [Accepted: 05/29/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Malignant tumor of the vulva is the fourth gynecological malignancy in frequency. Close to 70% of all vulvar malignancies are related to high-risk human papillomavirus (HPV) infection. METHODS A search for non-HPV-related malignant tumors of the vulva was performed in the last 20 years (2000-2020) in the pathology database of a single tertiary institution. We aim to estimate the prevalence of non-HPV-related malignancies in our population, describe clinicopathological features of these tumors and investigate the expression of some potential therapeutic targets. RESULTS A total of 71 patients were recovered; 26 patients (36%) had the diagnosis of extramammary Paget disease, 17 patients (24%) had basal cell carcinomas, 17 patients (24%) had primary melanomas, 10 patients (14%) had metastatic disease to the vulva and one patient (1%) had a primary dermatofibrosarcoma protuberans. Fifty-four percent of patients with extramammary Paget disease had a secondary malignancy and 12.5% had invasive disease. Programmed death-ligand 1 (PDL-1) was positive in seven out of nine primary melanomas and Her2/neu was overexpressed in six out of seven extramammary Paget disease. CONCLUSION Non-HPV-related malignancies are important differential diagnoses in patient with vulvar lesions. Additional research is necessary to further understand these complex malignancies and potential new therapeutic targets.
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Affiliation(s)
- Karina Furlan
- Department of Pathology, Rush University Medical Center, Chicago, Illinois, USA
| | - Prih Rohra
- Department of Pathology, Rush University Medical Center, Chicago, Illinois, USA
| | - Fatima Mir
- Department of Pathology, Rush University Medical Center, Chicago, Illinois, USA
| | - Paolo Gattuso
- Department of Pathology, Rush University Medical Center, Chicago, Illinois, USA
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Catteau X, D'haene N, Noël JC. Low grade malignant eccrine spiradenoma of the vulva: case report, review of the literature and discussion about the role of p53 and HPV. Diagn Pathol 2020; 15:24. [PMID: 32169099 PMCID: PMC7071686 DOI: 10.1186/s13000-020-00945-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malignant eccrine spiradenoma is one of the rarest sweat-gland tumors. Here, we describe a rare case of low grade malignant eccrine spiradenoma located at the vulva. CASE PRESENTATION The vulvar lesion was described as a mass measured 3.5 cm and located in the dermis and subcutis with no attachment to the epidermis. The neoplasm was arranged in ragged sheets or solid nodules sometimes with focal necrosis. The tumor cells had hyperchromatism, pleomorphism, and prominent nucleoli with high mitotic index and KI-67 estimated at 70-80%. CONCLUSIONS It's only the fifth case of malignant eccrine spiradenoma localized at the vulva. This is the first time that an HPV genotyping was made in this type of lesion with no HPV found while the p16 expression was diffuse. Moreover, it's the first time that a p53 mutation is detected by sequencing in this location.
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Affiliation(s)
- Xavier Catteau
- CUREPATH (Chirec institute- Brussels, CHU Tivoli - La Louvière), Rue de Borfilet, 12A, 6040 Jumet, Charleroi, Belgium. .,Pathology Department, Erasme University Hospital, Université Libre de Bruxelles, CP 610, Route de Lennik, 808, 1070, Brussels, Belgium.
| | - Nicky D'haene
- Pathology Department, Erasme University Hospital, Université Libre de Bruxelles, CP 610, Route de Lennik, 808, 1070, Brussels, Belgium
| | - Jean-Christophe Noël
- Pathology Department, Erasme University Hospital, Université Libre de Bruxelles, CP 610, Route de Lennik, 808, 1070, Brussels, Belgium
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Loiacono RMR, Traversi P, Deliso MA, Gargano G, Kardhashi A, Francescato R, Loizzi V, Spinelli M, Lovascio S, Fiorito M, Resta L, Popescu O, Cicinelli E, Cormio G. Paget disease of the vulva an analysis of 24 cases. Medicine (Baltimore) 2019; 98:e17018. [PMID: 31593076 PMCID: PMC6799860 DOI: 10.1097/md.0000000000017018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Paget's disease can arise in the breast (mammary Paget disease) or in other locations (extramammary Paget disease) such as anogenital skin in both males and females (Paget disease of the vulva [PDV]). Underlying adenocarcinoma can be found in some cases. This study aims to report clinical aspects, surgical procedures, outcomes, and recurrences of patients with PDV.A retrospective chart review was conducted on patients with pathologically confirmed diagnosis of PDV managed at the Department of Obstetrics and Gynecology, University of Bari, and the "Giovanni Paolo II" National Cancer Institute in Bari, between 1998 and 2018.Records of 24 cases of PDV were examined. Median age of the patients at diagnosis was 69.3 (range 38-84), diagnosis of synchronous cancer was made in 2 cases and in 2 other cases of metachronous disease. Three patients had previously been diagnosed with other oncological diseases. All patients underwent surgery including wide local excision (6), simple vulvectomy (8), and extended vulvectomy (10). Lymphadenectomy was performed in 2 cases and reconstructions with advancement flaps in 7 cases. Four patients were found to have invasive disease and 1 had inguinal node involvement. Positive margins were found in 11 patients. Wound dehiscence and urethral stenosis were found in 4 and 1 case each. Eight recurrences (33.33%) were observed, regardless of positive surgical margins.PDV has a low rate of malignancy but a high rate of recurrence. It should be diagnosed early to avoid repeated surgery and to reduce symptoms and morbidity.
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Affiliation(s)
| | | | | | - Giulio Gargano
- Gynecologic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”
| | - Anila Kardhashi
- Gynecologic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”
| | | | | | | | | | | | | | - Ondina Popescu
- Department of Pathology, IRCCS Istituto Tumori “Giovanni Paolo II,” Bari, Italy
| | | | - Gennaro Cormio
- Gynecologic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”
- Department of Obstetrics and Gynecology
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25
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Blind A, Weingertner N, Cribier B. Étude anatomoclinique et immunohistochimique d’une tumeur dérivant des glandes ano-génitales de type mammaire : l’hidradénome papillifère. Ann Dermatol Venereol 2019; 146:528-536. [DOI: 10.1016/j.annder.2019.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 12/22/2018] [Accepted: 03/01/2019] [Indexed: 10/26/2022]
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Primary Mammary Analog Secretory Carcinoma (MASC) of the Vulva With ETV6-NTRK3 Fusion: A Case Report. Int J Gynecol Pathol 2019; 38:283-287. [PMID: 29672325 DOI: 10.1097/pgp.0000000000000501] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Mammary analog secretory carcinoma is a primary salivary gland neoplasm with histologic, immunophenotypic, and molecular features identical to those of secretory carcinoma of the breast. Similar neoplasms have now been reported to occur in various nonmammary sites including the parotid gland, submandibular gland, sinuses, lip, skin, thyroid gland, and lung. We report, to our knowledge, the first example of a primary vulvar neoplasm with pathologic features identical to secretory carcinoma of the breast and an ETV6-NTRK3 fusion.
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Tan A, Bieber AK, Stein JA, Pomeranz MK. Diagnosis and management of vulvar cancer: A review. J Am Acad Dermatol 2019; 81:1387-1396. [PMID: 31349045 DOI: 10.1016/j.jaad.2019.07.055] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 07/12/2019] [Accepted: 07/16/2019] [Indexed: 12/19/2022]
Abstract
Vulvar malignancies represent a serious gynecologic health concern, especially given the increasing incidence over the past several decades. Squamous cell carcinoma and melanoma are common subtypes, although other neoplasms, such as basal cell carcinoma and Paget disease of the vulva, might be seen. Many vulvar cancers are initially misdiagnosed as inflammatory conditions, delaying diagnosis and worsening prognosis. It is essential that dermatologists are familiar with characteristic findings for each malignancy to ensure appropriate diagnosis and management. Herein, we review the unique epidemiologic and clinical characteristics of each major vulvar malignancy, as well as discuss their respective prognoses and current management recommendations.
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Affiliation(s)
- Andrea Tan
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
| | - Amy K Bieber
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
| | - Jennifer A Stein
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
| | - Miriam K Pomeranz
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.
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Extensive Squamous Metaplasia in Hidradenoma Papilliferum of Vulva: Illusion of Squamous Cell Carcinoma. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2019. [DOI: 10.1007/s40944-019-0276-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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[Ectopic tissue of the female genital tract]. DER PATHOLOGE 2018; 39:424-430. [PMID: 30155695 DOI: 10.1007/s00292-018-0477-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Ectopias of female genital tissues are a common event in routine pathology. Mostly they derive from paramesonephric tissues displaced during embryonal development or later. However, gonadal-, mesonephric-, or mesothelial-derived tissues may also appear in unusual localizations in and outside the female genital tract. They may be the source of benign and malignant tumors or tumor-like lesions. This review aims to provide an overview of possible tissue ectopias and to improve the developmental understanding of tumorous diseases of the female genital tract. Ectopias of primarily extragenital tissues in the female genital tract are also reviewed.
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Feito J, Cebrián-Muiños C, Alonso-Morrondo EJ, García-Mesa Y, García-Piqueras J, Cobo R, García-Suárez O, Vega JA. Hyperplastic sensory corpuscles in nevus sebaceus of labia minora pudendi. A case report. J Cutan Pathol 2018; 45:777-781. [DOI: 10.1111/cup.13316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/05/2018] [Accepted: 06/25/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Jorge Feito
- Servicio de Anatomía Patológica; Complejo Hospitalario de Salamanca; Salamanca Spain
- Departamento de Morfología y Biología Celular; Grupo SINPOS, Universidad de Oviedo; Oviedo Spain
| | | | | | - Yolanda García-Mesa
- Departamento de Morfología y Biología Celular; Grupo SINPOS, Universidad de Oviedo; Oviedo Spain
| | - Jorge García-Piqueras
- Departamento de Morfología y Biología Celular; Grupo SINPOS, Universidad de Oviedo; Oviedo Spain
| | - Ramón Cobo
- Departamento de Morfología y Biología Celular; Grupo SINPOS, Universidad de Oviedo; Oviedo Spain
| | - Olivia García-Suárez
- Departamento de Morfología y Biología Celular; Grupo SINPOS, Universidad de Oviedo; Oviedo Spain
| | - José Antonio Vega
- Departamento de Morfología y Biología Celular; Grupo SINPOS, Universidad de Oviedo; Oviedo Spain
- Facultad de Ciencias de la Salud; Universidad Autónoma de Chile; Temuco Chile
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Eccrine Spiradenoma of the Vulva. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2018. [DOI: 10.1007/s40944-018-0198-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
INTRODUCTION Spiradenocarcinomas (SCs) are rare and potentially aggressive skin adnexal tumors. Optimal treatment has not yet been established. Experiences with this carcinoma are mostly presented in case reports and few case series. OBJECTIVE To generate to a synopsis of published data on SC with regard to diagnostic procedures, treatment, and outcome. RESULTS Median patient age was 60 years and sex distribution was balanced. Tumor manifestations were evenly distributed within the sweat gland carrying skin. The most commonly reported symptom was accelerated growth of a longstanding indolent lesion, typically present for more than 2 years. Metastatic spread to the lung, bone, lymph nodes, liver, kidney, and breast has been documented. For staging computed tomography (CT) and positron emission tomography-CT are recommended, especially for detection of hematogenic metastases and lymph node involvement. Clear resection margins and tumor free regional lymph nodes reduce recurrence and carcinoma related death. Although low-grade SCs were reported over 3 times more often, high-grade carcinomas show a greater likelihood for recurrence and lethal outcome. CONCLUSION Suspicion of an SC should lead to performance of a magnetic resonance imaging for defining tumor extent, and a fludeoxyglucose positron emission tomography-CT for detection of metastases. Radical tumor excision and resection of tumor involved regional lymph nodes are essential for a curative approach. Histopathological evaluation should involve determination of tumor differentiation grade, because high-grade carcinomas seem to have a much more aggressive behavior. Excision of distant metastases has no therapeutic value. Follow-up needs to be carried out in short intervals with frequent imaging.
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Extramammary Paget Disease of the Vulva: A Case Series Examining Treatment, Recurrence, and Malignant Transformation. Int J Gynecol Cancer 2018; 28:632-638. [DOI: 10.1097/igc.0000000000001189] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
ObjectivesExtramammary Paget disease (EMPD) of the vulva is a rare lesion with a high recurrence rate ranging from 12% to 61%. The rate of underlying adenocarcinoma varies, but in the largest series was reported at 4%. Given the rarity of the disease there is a paucity of data to optimize treatment. This study aims to describe the management and recurrence patterns in a tertiary care setting and to offer suggestions for management in a modern-day setting.MethodsPatients with pathologically confirmed EMPD treated from 2000 to 2015 were retrospectively identified using an IRB approved database. Clinical data were abstracted from the electronic medical record. Pathology underwent central review.ResultsForty-four patients met criteria and underwent central pathology review. Forty-two patients were treated with surgical excision. Alternative treatment modalities included Mohs surgery in 3 patients and medical therapy in 20 patients. The median number of surgical procedures was 1 and the number of procedures ranged from 1 to 16. Twenty-five patients (56.8%) had recurrent disease with a median of 2 (1-6) recurrences per patient. The median disease-free interval was 28.7 months with a median follow up of 45.8 months (1.2-178.9 months). Three patients (7%) had invasive cancer and 7 patients (16%) were diagnosed with a separate malignancy at or following diagnosis of EMPD. Despite radical resection, the majority of patients had positive margins and there was no significant difference in disease recurrence between simple and radical resection (P = 0.69).ConclusionsPatients with EMPD in this series have a high rate of recurrence. Many undergo multi-modal therapy often with multiple providers. However, patients experience relatively long disease-free intervals with a low rate of associated malignancy. We propose an algorithm for management that focuses on symptom control and minimizing morbidity of treatment intervention once invasive disease has been excluded.
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Abstract
ObjectiveExtramammary Paget disease of the vulva (EPDV) is a rare occurrence with an indolent and relapsing course. Progression to invasion occurs in 4% to 19% of cases. The aim of this study is to report clinical-pathological features and outcomes of patients treated for invasive EPDV.MethodsData of consecutive patients treated between 2000 and 2017 for invasive EPDV were reviewed.ResultsAmong 79 patients with EPDV, 10 (12.7%) presented a microinvasive or invasive form at first diagnosis or during follow-up. All of them underwent upfront radical surgery; 7 (70%) received subsequent radiotherapy, chemotherapy, or both. The mortality rate was 40%. The recurrence rate after treatment for invasive forms was 60%, with a mean time to first recurrence of 20 (range, 5–36) months.ConclusionsOur study confirms that invasive EPDV remains a rare gynecological neoplasm with a poor prognosis. Multicentre trials or well-organized prospective data collection could improve the knowledge about the management of invasive EPDV.
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Poroid Condyloma Versus Poroma With Atypias Because of Human Papillomavirus Infection. Appl Immunohistochem Mol Morphol 2017; 25:e14-e17. [PMID: 28177975 DOI: 10.1097/pai.0000000000000377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We present the case of a 43-year-old white man with a complex lesion at the base of the penis that combines features of both a poroma and a condyloma with human papillomavirus (HPV) infection, atypias, and focal ductal differentiation. It was a papillomatous lesion with epidermal hyperplasia, which mainly contained focally pigmented monotonous basaloid cells. Ductal lumina with cuticular cells were easily identified. Atypias were focally evidenced, with nuclear enlargement and hyperchromasia. Hypergranulosis and koilocytosis were also present. Immunohistochemical studies indicated p16 and p53 immunoexpression in the areas with cellular atypia and koilocytosis. Studies with in situ hybridization showed positivity for HPVs 16/18 and 31/33 in such areas, with a high rate of proliferation indicated by Ki-67. There was no positivity for HPV 6/11. Epithelial membrane antigen highlighted the ductal lumina, whereas there was no immunostaining for carcinoembryonic antigen.
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Hernández-Angeles C, Nadal A, Castelo-Branco C. Hidradenoma papilliferum of the vulva in a postpartum woman: A case report. J OBSTET GYNAECOL 2017; 37:683-684. [PMID: 28287283 DOI: 10.1080/01443615.2017.1284186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Claudio Hernández-Angeles
- a Hospital Ginecoobstetricia Número 4 "Luis Castelazo Ayala", Instituto Mexicano del Seguro Social , México , Mexico
| | - Alfons Nadal
- b Department of Pathology , Hospital Clinic, Universitat de Barcelona, IDIBAPS , Barcelona , Spain
| | - Camil Castelo-Branco
- c Department of Gynecology & Obstetrics , Hospital Clinic, Universitat de Barcelona, IDIBAPS , Barcelona , Spain
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Incidence and survival of glandular vulvar malignancies in the Netherlands. Gynecol Oncol 2017; 144:553-557. [DOI: 10.1016/j.ygyno.2017.01.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 01/17/2017] [Accepted: 01/18/2017] [Indexed: 11/18/2022]
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Goto K, Maeda D, Kudo-Asabe Y, Hibiya T, Hayashi A, Fukayama M, Ohashi K, Goto A. PIK3CA and AKT1 mutations in hidradenoma papilliferum. J Clin Pathol 2016; 70:424-427. [PMID: 27742746 DOI: 10.1136/jclinpath-2016-204003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 09/12/2016] [Accepted: 09/23/2016] [Indexed: 11/03/2022]
Abstract
AIMS Hidradenoma papilliferum (HP) is a benign vulvar neoplasm that arises from anogenital mammary-like glands, and its morphology is similar to mammary intraductal papilloma. The aim of this study was to investigate oncogenic mutations involved in the tumourigenesis of HP. We focused specifically on PIK3CA and AKT1 mutations, which are both reported to be detected in 33% of mammary intraductal papillomas. METHODS In total, seven HP cases were analysed. Clinicopathological analyses and immunohistochemistry for oestrogen receptor, p63, smooth muscle actin (SMA), p53 and β-catenin were performed. Furthermore, PIK3CA, AKT1, BRAF and KRAS hot spot mutations were examined by Sanger sequencing. RESULTS Morphologically, all HPs had a papillary and tubular architecture with a biphasic pattern of epithelial and myoepithelial cells. Immunohistochemistry revealed that oestrogen receptor expression was restricted to epithelial cells, whereas p63 and SMA were exclusively expressed in myoepithelial cells. The patterns of p53 and β-catenin immunostaining suggested wild-type genotypes. Direct sequencing revealed the presence of somatic PIK3CA mutations (Ex9. c.1633G>A, p.E545K and Ex20. c.3140A>G, p.H1047R) in two of the HPs and an AKT1 (c.49G>A, p.E17K) mutation in one. BRAF and KRAS mutations were not found in any of the HP cases. CONCLUSIONS PIK3CA and AKT1 are frequently mutated in HP tumours (29% and 14%, respectively). PIK3CA/AKT1 pathway alterations in HP further support the hypothesis that HP is the vulvar (anogenital mammary-like gland) analogue of breast intraductal papilloma.
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Affiliation(s)
- Keisuke Goto
- Department of Diagnostic Pathology, Kainan Hospital, Aichi, Japan.,Department of Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden
| | - Daichi Maeda
- Department of Cellular and Organ Pathology, Graduate School of Medicine, Akita University, Akita, Japan
| | - Yukitsugu Kudo-Asabe
- Department of Cellular and Organ Pathology, Graduate School of Medicine, Akita University, Akita, Japan
| | - Takashi Hibiya
- Department of Pathology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Akimasa Hayashi
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masashi Fukayama
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenichi Ohashi
- Department of Pathology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Akiteru Goto
- Department of Cellular and Organ Pathology, Graduate School of Medicine, Akita University, Akita, Japan
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Ciarloni L, Frouin E, Bodin F, Cribier B. Syringoma: A clinicopathological study of 244 cases. Ann Dermatol Venereol 2016; 143:521-8. [PMID: 27112697 DOI: 10.1016/j.annder.2015.06.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/18/2015] [Accepted: 06/23/2015] [Indexed: 10/21/2022]
Abstract
BACKGROUND Syringomas are benign tumours of the sweat glands, the most familiar clinical presentation of which is the presence of multiple lesions on the eyelids. The aim of our study was to determine the clinical and histological characteristics of a large series of patients and to examine anatomoclinical correlations. PATIENTS AND METHODS This was a retrospective study conducted in all of the cases of syringoma analysed at the cutaneous histopathology laboratory in Strasbourg between 1970 and 2008. The clinical elements, patient history and diagnostic data were collated. All slides were re-read in order to determine the microscopic characteristics of the lesions. RESULTS Two hundred and forty-four lesions were included. The sex ratio was 0.27 and the mean age was 42 years (8 to 85 years). Multiple syringomas were noted in 76% of cases, of which 29.2% were eruptive, and one case occurred in a setting of metastatic melanoma. The sites of predilection were the face (56.7%, of which 36.3% on the eyelids), the chest (18.1%) and the neck (17.5%) for the multiple forms. The lesions were in the form of papules (67%), either brown (34.2%) or flesh-coloured (19.8%). Pruritus was reported in 14 cases, including 4 at vulvar sites (out of a total of 8). A diagnosis of syringoma was made by the clinician in only 30.2% of the multiple forms, with mastocytosis being proposed in 7.1% of cases. The clear-cell forms (18 cases) presented no special clinical features. CONCLUSION Syringomas are frequently multiple and are seen mainly in women. They are found predominantly on the face and trunk, and lesions are generally brown and pruritic, a little-known feature that accounts for the degree of diagnostic confusion with mastocytosis. The vulvar forms, which are often pruritic, are poorly known. The eruptive forms may include a hormonal component.
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Affiliation(s)
- L Ciarloni
- Clinique dermatologique, faculté de médecine, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France
| | - E Frouin
- Service d'anatomie et de cytologie pathologiques, hôpital Jean-Bernard, 2, rue de la Milétrie, 86021 Poitiers cedex, France.
| | - F Bodin
- Service de chirurgie plastique, faculté de médecine, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'hôpital, 67091 Strasbourg, France
| | - B Cribier
- Clinique dermatologique, faculté de médecine, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France
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41
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El-Khoury J, Renald MH, Plantier F, Avril MF, Moyal-Barracco M. Vulvar hidradenoma papilliferum (HP) is located on the sites of mammary-like anogenital glands (MLAGs): Analysis of the photographs of 52 tumors. J Am Acad Dermatol 2016; 75:380-4. [PMID: 26944596 DOI: 10.1016/j.jaad.2016.01.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 01/15/2016] [Accepted: 01/30/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hidradenoma papilliferum (HP) is a benign tumor that primarily affects the anogenital area of adult women. Previously considered apocrine tumors, anogenital HP tumors are now interpreted as adenomas of mammary-like anogenital glands based on their histologic features. OBJECTIVE This clinical study was undertaken to determine whether vulvar HP is located on mammary-like anogenital gland sites and to describe its morphologic features. METHODS The clinical photographs of 52 histologically confirmed vulvar HP provided by 7 vulva specialists were analyzed. RESULTS In all, 90.4% of the HP were located on the interlabial sulcus, adjacent zone, or the perineum. These tumors were polymorphous in terms of number (1 or multiple), size (<1-4.5 cm), color (pink, red, blue), surface (ulcerated or not), and architecture (unilobular or multilobular). LIMITATIONS Eight histologic reports could not be reviewed by the authors but the contributors confirmed that the photographs sent were only those of histologically confirmed HPs. CONCLUSIONS Vulvar HP is mainly located on mammary-like anogenital gland sites, thereby providing further evidence to their histogenesis. Although a nonulcerated or ulcerated tumor of the interlabial sulcus should evoke a HP diagnosis, the latter must be confirmed histologically.
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Affiliation(s)
- Jinane El-Khoury
- Department of Dermatology, University Medical Center-Rizk Hospital, Beirut, Lebanon
| | - Marie-Hélène Renald
- Department of Obstetrics and Gynecology, Hôpital Hôtel-Dieu de Lévis, Montreal, Quebec, Canada
| | - Françoise Plantier
- Department of Pathology, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Marie-Françoise Avril
- Department of Dermatology, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin Tarnier, Paris, France; Faculté de Médecine Paris 5 Descartes, Paris, France
| | - Micheline Moyal-Barracco
- Department of Dermatology, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin Tarnier, Paris, France.
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Kalampalikis A, Scheungraber C, Goetze S, Schliemann S, Elsner P. [Isolated epidermal cysts of the vulva]. Hautarzt 2016; 67:553-4. [PMID: 26857133 DOI: 10.1007/s00105-016-3767-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Vulvar cysts are rare und benign entities. They are epidermoid cysts which may develop following trauma or surgery. They can also spontaneously develop. They vary in number and size. They grow slowly and tend to show calcification. The treatment consists of surgical removal. Other methods are pinch-punch excision, heat application, and incision.
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Affiliation(s)
- A Kalampalikis
- Klinik für Hautkrankheiten, Universitätsklinikum Jena, Erfurter Straße 35, 07743, Jena, Deutschland.
| | - C Scheungraber
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Jena, Jena, Deutschland
| | - S Goetze
- Klinik für Hautkrankheiten, Universitätsklinikum Jena, Erfurter Straße 35, 07743, Jena, Deutschland
| | - S Schliemann
- Klinik für Hautkrankheiten, Universitätsklinikum Jena, Erfurter Straße 35, 07743, Jena, Deutschland
| | - P Elsner
- Klinik für Hautkrankheiten, Universitätsklinikum Jena, Erfurter Straße 35, 07743, Jena, Deutschland
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Williams K, Shinkai K. Evaluation and management of the patient with multiple syringomas: A systematic review of the literature. J Am Acad Dermatol 2016; 74:1234-1240.e9. [PMID: 26850654 DOI: 10.1016/j.jaad.2015.12.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 12/01/2015] [Accepted: 12/05/2015] [Indexed: 11/24/2022]
Abstract
Syringomas are benign adnexal tumors with distinct histopathologic features, including the characteristic comma ("tadpole") shaped tail comprised of dilated, cystic eccrine ducts. Clinically, syringomas typically present in adolescent females predominantly in the periorbital region. They may present as solitary or multiple lesions, and more rare sites of involvement include the genitals, palms, scalp, and the chest. Over the past 50 years, there have been >800 reported cases of syringoma either alone or in conjunction with a systemic syndrome, most commonly Down syndrome. The primary aim of this systematic review is to discuss the clinical features and associations of syringomas with a focus on the patient with multiple syringomas. Its secondary aims are to explore pathophysiology with a focus on multiple syringomas and provide comprehensive data on both traditional and novel treatments. Importantly, multiple syringomas present across a broad clinical spectrum. Though noted in many textbooks to be related to tumor syndromes, the association of syringomas with inherited tumor syndromes is only rarely reported in the literature. Despite multiple reported cases of syringoma, the pathophysiology remains poorly understood and treatment continues to pose a significant challenge.
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Affiliation(s)
- Kiyanna Williams
- University of California San Francisco School of Medicine, San Francisco, California
| | - Kanade Shinkai
- Department of Dermatology, University of California San Francisco, San Francisco, California.
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Pfarr N, Sinn HP, Klauschen F, Flechtenmacher C, Bockmayr M, Ridinger K, von Winterfeld M, Warth A, Lorenz K, Budczies J, Penzel R, Lennerz JK, Endris V, Weichert W, Stenzinger A. Mutations in genes encoding PI3K-AKT and MAPK signaling define anogenital papillary hidradenoma. Genes Chromosomes Cancer 2015; 55:113-9. [DOI: 10.1002/gcc.22315] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/10/2015] [Accepted: 09/11/2015] [Indexed: 12/27/2022] Open
Affiliation(s)
- Nicole Pfarr
- Institute of Pathology, Technical University Munich (TUM); Trogerstrasse 18 Munich 81675 Germany
| | - Hans-Peter Sinn
- Institute of Pathology, University Hospital Heidelberg; Heidelberg 69120 Germany
| | | | | | - Michael Bockmayr
- Institute of Pathology, Charité University Hospital; Berlin 10117 Germany
| | - Kathrin Ridinger
- Institute of Pathology, University Hospital Heidelberg; Heidelberg 69120 Germany
| | | | - Arne Warth
- Institute of Pathology, University Hospital Heidelberg; Heidelberg 69120 Germany
| | - Katja Lorenz
- Institute of Pathology, University Hospital Heidelberg; Heidelberg 69120 Germany
| | - Jan Budczies
- Institute of Pathology, Charité University Hospital; Berlin 10117 Germany
| | - Roland Penzel
- Institute of Pathology, University Hospital Heidelberg; Heidelberg 69120 Germany
| | - Jochen K. Lennerz
- Department of Pathology; Center for Integrated Diagnostics (CID), Massachusetts General Hospital/Harvard Medical School; Boston MA 02114
| | - Volker Endris
- Institute of Pathology, University Hospital Heidelberg; Heidelberg 69120 Germany
| | - Wilko Weichert
- Institute of Pathology, Technical University Munich (TUM); Trogerstrasse 18 Munich 81675 Germany
- Institute of Pathology, University Hospital Heidelberg; Heidelberg 69120 Germany
- National Center for Tumor Diseases (NCT); Heidelberg Germany
- German Cancer Consortium (DKTK); Heidelberg Germany
| | - Albrecht Stenzinger
- Institute of Pathology, University Hospital Heidelberg; Heidelberg 69120 Germany
- National Center for Tumor Diseases (NCT); Heidelberg Germany
- National Center of Tumor Diseases-Heidelberg School of Oncology (NCT-HSO); Heidelberg Germany
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46
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Affiliation(s)
- F Plantier
- Service de dermatologie, hôpital Tarnier-Cochin, 89, rue d'Assas, 75006 Paris, France.
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Berdugo J, Gauthier P, Provencher D, Matte C, Piché J, Rahimi K. Spindle Cell Epithelioma of the Vagina. Int J Surg Pathol 2015; 23:677-81. [DOI: 10.1177/1066896915587920] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Spindle cell epitheliomas of the vagina are rare benign tumors of uncertain histogenesis. It has been hypothesized that they originate from a pluripotent cell population. Here, we report 2 cases of spindle cell epitheliomas of the vagina. Both patients presented with a painless vaginal nodule. The resected lesions were solid, well circumscribed, and composed of a proliferation of epithelioid or epithelial cells admixed with spindle cells without atypia. The 2 cellular populations expressed epithelial and mesenchymal markers. Based on these morphologic and immunohistochemical findings, a diagnosis of spindle cell epithelioma was rendered in both cases. Furthermore, we describe for the first time the expression of WT-1 (Wilms’ tumor protein 1) and calretinin in addition to the previously defined immunohistochemical profile.
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Affiliation(s)
- Jérémie Berdugo
- Department of pathology, Université de Montréal, CHUM, Montréal, Québec, Canada
| | - Philippe Gauthier
- Department of gynecologic oncology, Université de Montréal, CHUM, Montréal, Québec, Canada
| | - Diane Provencher
- Department of gynecologic oncology, Université de Montréal, CHUM, Montréal, Québec, Canada
| | - Claire Matte
- Université de Sherbrooke, Hôpital Charles-LeMoyne, Longueil, Québec, Canada
| | - Jean Piché
- Hôpital Pierre-Boucher, Longueil, Québec, Canada
| | - Kurosh Rahimi
- Department of pathology, Université de Montréal, CHUM, Montréal, Québec, Canada
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