Metachronous squamous neoplasias of the cervix and vulva

S. Nastasia, A. Ghelmene, I. Briceag, A. Maniu, M. Russu

Rezumat: We describe the case of a patient with invasive cervical carcinoma, irradiated and operated according to protocols, who was later operated for invasive vulvar carcinoma. Simple, moderate, severe vulvar dysplasia (VIN III) and areas of invasive squamous vulvar carcinoma were discovered on pathology suggesting that the vulvar lesion occurred and evolved locally, as a primary vulvar lesion, and not as a vulvar spread of the previous cervical carcinoma. Additionally, the slow evolution rate of the vulvar lesion seems incompatible with the evolution of a metastasis from a distant carcinoma. Although high risk HPV infections is accepted as a common etiology for cervical and vulvar neoplasms, the pathogenesis of metachronous squamous lesions on the cervix and vulva is unclear, especially at genomic level and the debate, as to whether multicentric CIN 3/carcinoma in situ/invasive carcinoma lesions arise independently, de novo at different sites, or share a monoclonal origin, is still continuing.
Cuvinte cheie: metachronous squamous lesions, clonal origin, cervix, vulva.