Unveiling a Dermatological Rarity: The Enigma of Vulvar Intraepithelial Neoplasia Grade III (HSIL) and the Role of P53 in Its Development

Overview

Journal Biomedicines

Specialty Biomedical Engineering

Date 2024 Aug 29

PMID 39200263

Authors

Piotr Brzezinski

Igor Feszak

Beatriz Di Martino Ortiz

Sylwia Feszak

Piotr Kawczak

Tomasz Baczek

Affiliations

Soon will be listed here.

Abstract

Vulvar intraepithelial neoplasia, also known as VIN, is a non-invasive squamous lesion and precursor of squamous cell carcinoma (SCC) of the vulva. There is no screening test for vulvar intraepithelial neoplasia. Diagnosis of VIN is made clinically and confirmed with a biopsy. We describe a 66-year-old woman with a condyloma-like tumour located in the skin on the vestibule of the vagina. A biopsy sample was taken from the nodule. The definitive diagnosis is supported by the histological examination (VIN III) and immunohistochemical examination of p16(+), p53(+), and a few cell nuclei. The case provides information on the importance of multidisciplinary cooperation. Lifelong surveillance is essential since the resection of individual lesions does not guarantee the prevention of invasive cancer.

References

Dehlendorff C, Baandrup L, Kjaer S . Real-World Effectiveness of Human Papillomavirus Vaccination Against Vulvovaginal High-Grade Precancerous Lesions and Cancers. J Natl Cancer Inst. 2020; 113(7):869-874. PMC: 8246827. DOI: 10.1093/jnci/djaa209. View

Jones R . Vulval intraepithelial neoplasia: current perspectives. Eur J Gynaecol Oncol. 2002; 22(6):393-402. View

Gage J, Schiffman M, Hunt W, Joste N, Ghosh A, Wentzensen N . Cervical histopathology variability among laboratories: a population-based statewide investigation. Am J Clin Pathol. 2013; 139(3):330-5. PMC: 4125616. DOI: 10.1309/AJCPSD3ZXJXP7NNB. View

Terlou A, van Seters M, Ewing P, Aaronson N, Gundy C, Heijmans-Antonissen C . Treatment of vulvar intraepithelial neoplasia with topical imiquimod: seven years median follow-up of a randomized clinical trial. Gynecol Oncol. 2011; 121(1):157-62. DOI: 10.1016/j.ygyno.2010.12.340. View

Bornstein J, Bogliatto F, Haefner H, Stockdale C, Preti M, Bohl T . The 2015 International Society for the Study of Vulvovaginal Disease (ISSVD) Terminology of Vulvar Squamous Intraepithelial Lesions. J Low Genit Tract Dis. 2015; 20(1):11-4. DOI: 10.1097/LGT.0000000000000169. View

Rodolakis A, Diakomanolis E, Vlachos G, Iconomou T, Protopappas A, Stefanidis C . Vulvar intraepithelial neoplasia (VIN)--diagnostic and therapeutic challenges. Eur J Gynaecol Oncol. 2003; 24(3-4):317-22. View

Thuis Y, Campion M, Fox H, Hacker N . Contemporary experience with the management of vulvar intraepithelial neoplasia. Int J Gynecol Cancer. 2001; 10(3):223-227. DOI: 10.1046/j.1525-1438.2000.010003223.x. View

Sideri M, Jones R, Wilkinson E, Preti M, Heller D, Scurry J . Squamous vulvar intraepithelial neoplasia: 2004 modified terminology, ISSVD Vulvar Oncology Subcommittee. J Reprod Med. 2006; 50(11):807-10. View

. Committee Opinion No. 704: Human Papillomavirus Vaccination. Obstet Gynecol. 2017; 129(6):1. DOI: 10.1097/AOG.0000000000002052. View

10.

Woelber L, Prieske K, Eulenburg C, Oliveira-Ferrer L, de Gregorio N, Klapdor R . p53 and p16 expression profiles in vulvar cancer: a translational analysis by the Arbeitsgemeinschaft Gynäkologische Onkologie Chemo and Radiotherapy in Epithelial Vulvar Cancer study group. Am J Obstet Gynecol. 2021; 224(6):595.e1-595.e11. DOI: 10.1016/j.ajog.2020.12.1220. View

11.

Zawacka-Pankau J . The Role of p53 Family in Cancer. Cancers (Basel). 2022; 14(3). PMC: 8833922. DOI: 10.3390/cancers14030823. View

12.

Stone S, Jiang P, Dayananth P, Tavtigian S, Katcher H, Parry D . Complex structure and regulation of the P16 (MTS1) locus. Cancer Res. 1995; 55(14):2988-94. View

13.

Liebl M, Hofmann T . The Role of p53 Signaling in Colorectal Cancer. Cancers (Basel). 2021; 13(9). PMC: 8125348. DOI: 10.3390/cancers13092125. View

14.

Marei H, Althani A, Afifi N, Hasan A, Caceci T, Pozzoli G . p53 signaling in cancer progression and therapy. Cancer Cell Int. 2021; 21(1):703. PMC: 8709944. DOI: 10.1186/s12935-021-02396-8. View

15.

Fox H, Wells M . Recent advances in the pathology of the vulva. Histopathology. 2003; 42(3):209-16. DOI: 10.1046/j.1365-2559.2003.01578.x. View

16.

Newcomb P, Weiss N, Daling J . Incidence of vulvar carcinoma in relation to menstrual, reproductive, and medical factors. J Natl Cancer Inst. 1984; 73(2):391-6. DOI: 10.1093/jnci/73.2.391. View

17.

Rahme R, Braun T, Manfredi J, Fenaux P . TP53 Alterations in Myelodysplastic Syndromes and Acute Myeloid Leukemia. Biomedicines. 2023; 11(4). PMC: 10136154. DOI: 10.3390/biomedicines11041152. View

18.

Thuijs N, van Beurden M, Duin S, Heideman D, Berkhof J, Steenbergen R . High-grade vulvar intraepithelial neoplasia: comprehensive characterization and long-term vulvar carcinoma risk. Histopathology. 2023; 84(2):301-314. DOI: 10.1111/his.15050. View

19.

Wong R, Cheung A . Predictive and prognostic biomarkers in female genital tract tumours: an update highlighting their clinical relevance and practical issues. Pathology. 2024; 56(2):214-227. DOI: 10.1016/j.pathol.2023.10.013. View

20.

Munoz N, Kjaer S, Sigurdsson K, Iversen O, Hernandez-Avila M, Wheeler C . Impact of human papillomavirus (HPV)-6/11/16/18 vaccine on all HPV-associated genital diseases in young women. J Natl Cancer Inst. 2010; 102(5):325-39. DOI: 10.1093/jnci/djp534. View