Obstetrics and Gynecology, Anatomic pathology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan.
J Obstet Gynaecol Res. 2022 Nov;48(11):2982-2987. doi: 10.1111/jog.15389. Epub 2022 Aug 16.
We report a case of a 23-year-old pregnant woman (gravida 2 para 0, pregnancy 33 weeks and 3 days) with a history of laser ablation for cervical intraepithelial neoplasia-3 at 22 years. At initial visit, a 2 × 2 × 1-cm elevated mass was found on right labia majora. Biopsy results revealed squamous cell carcinoma of right labia; immunostaining revealed p16 positivity. Patient was diagnosed with human papillomavirus-related vulvar cancer. Selective cesarean section was performed at 36 weeks and 4 days of gestation. Postoperative histopathological diagnosis of squamous cell carcinoma, and 1.7-mm deep infiltrations led to vulvar cancer stage IB diagnosis. Reduction operation was performed, and postoperative follow-up of 1 year and 8 months revealed no recurrence. These results emphasize that small vulvar tumors during pregnancy should not be underestimated and histological examinations should be performed without hesitation. Careful observation and evaluation of tumors is necessary during pregnancy and after delivery because they may shrink postdelivery.
我们报告了一例 23 岁孕妇(孕 2 产 0,妊娠 33 周+3 天)的病例,她曾于 22 岁时因宫颈上皮内瘤变-3 行激光消融治疗。初诊时,右侧大阴唇发现一 2×2×1cm 大小的隆起性肿块。活检结果显示右侧大阴唇鳞状细胞癌;免疫组化显示 p16 阳性。患者被诊断为人乳头瘤病毒相关外阴癌。于妊娠 36 周+4 天行选择性剖宫产术。术后组织病理学诊断为鳞状细胞癌,浸润深度 1.7mm,诊断为外阴癌 IB 期。行缩小手术,术后 1 年 8 个月随访无复发。这些结果强调了妊娠期间不应低估小的外阴肿瘤,应毫不犹豫地进行组织学检查。因为产后肿瘤可能会缩小,所以需要在妊娠期间和产后仔细观察和评估肿瘤。