[Diagnosis and management of vulvar intraepithelial neoplasias and invasive vulvar cancers].

Abstract

Objective: Update on the diagnosis and management of vulvar intraepithelial neoplasia (VIN) and vulvar carcinoma.

Method: Review of the literature.

Results: The classification of VIN is leaning towards the development of two distinct anatomoclinical models. VIN of the usual type and of a differentiated type. New forms of treatment of preinvasive lesions that are less traumatic and as efficient will have to be evaluated in the future such as immunomodulators and photodynamic therapy. The invasive carcinoma is generally rapidly symptomatic and visible; however, more than one third of patients are still diagnosed at an advanced stage. New therapeutic alternatives are being examined such as the sentinel lymph node in early stages and the preoperative radiochemotherapy in advanced stages.

Conclusions: VIN and vulvar cancer need specialized treatment which may be mutilating, despite the fact that therapeutic options are well defined today and tend towards less aggressive surgery.