A 43-year-old caucasian women suffers from an extensive and
painful vulvar lesions. Prior to this presentation the patient was treated for
cervical cancer with surgical treatment and radio chemotherapy seven years ago.
A malignant and infectious cause of these lesions was excluded and Atypical
Vascular Lesion (AVL) of the vulva was diagnosed by histopathology. AVL is
defined as benign vascular proliferation with widened atypical vessels
interepidermal and in the deeper dermis. These lesions cause multiple small
papules and are mainly located in the radiation field after cancer treatment.
AVL embraces a histological spectrum that ranges from banal
appearing lesions closely resembling a lymphangioma circumscriptum to capillary
vascular proliferations with nuclear atypia resembling an angiosarcoma. The
patient was treated with a radical skinning vulvectomy for a complete resection
of the altered tissue. The patient did not relapse under a close follow up and
her quality of life improved, significantly.
AVL is a
rare disease that can be acquired especially after radiation for cervical
cancer therapy induced lymphedema. It presents with multiple cutaneous papules
that may cause pain along with other discomforting symptoms. The differential
diagnoses are infectious diseases such as genital herpes but also malignant
tumours such as angiosarcoma or cutaneous metastasis of a prior cancer.
A
43-year-old caucasian patient presented with a lesion of the vulva, declining
over the last four years. She suffered from itching, burning and swelling of
the vulva. The clinical examination revealed multiple small, wetted papules
covering the complete vulva. The lesions were most prominent confined to the
labium majus but had also emerged on the labia minora.
No comments:
Post a Comment