Pathology of the vulva.

Increasing agreement is being reached among the International Society for the Study of Vulvar Disease, the International Society of Gynecological Pathologists, the World Health Organization, and the International Federation of Gynecology and Obstetrics concerning the terminology used to describe the abnormalities of and surgical procedures for vulvar disease. This paper focuses on Paget's disease of the vulva, which is beset with recurrence and a higher incidence of invasive disease than previously recognized, although diagnostic methods have improved. Agreements on the definition for and measurement of superficially invasive squamous cell carcinoma of the vulva have also been reached. The prognostic features of tumors likely to be associated with nodal metastases are being delineated with a view to the use of conservative surgery. The risks in underestimating a tumor's capacity to metastasize are emphasized.