Invasive squamous carcinoma of the vulva in women aged less than 40 years: report of two cases and a third case diagnosed during pregnancy

Abstract

Purpose of investigation: Invasive squamous cell cancer of the vulva (ISCC) is a rare disease in young patients and in pregnant women. The purpose of this paper was to investigate this type of cancer in women less than 40 years old and to present three cases, one which was diagnosed in the third trimester of pregnancy. Methods: Three cases of invasive squamous cell cancer in women under age 40 among the retrospectively analyzed 52 vulvar cancer cases diagnosed between 1995-2002 were investigated. Results: Women aged 25, 39 and 3 1, respectively, had Stage 1, 2 and 3 ISCC of the vulva. The first two cases had been spared by surgery and radiotherapy. The third patient was diagnosed during the last trimester of pregnancy. Although she was treated by radical surgery and postoperative radiotherapy, she had a recurrence in the inguinal region at 36 months, and died of disease 12 months later. Conclusion: Vulvar ISCC in young women may occur in association with or without predisposing factors. Although HPV-related type is predominant in the literature, keratinizing type of carcinoma may also be seen in this group of patients. Biopsy from suspected lesions is of paramount importance.