obsolete vulvar tumor of skin appendage origin

Vulvar Tumors of Skin Appendage Origin: Obsolete Types

There are several types of vulvar tumors that originate from the skin appendages, which have been considered obsolete or rare in modern medical literature. These include:

• Trichoepithelioma: A benign tumor that is thought to arise from hair follicles. It typically presents as a small, solitary papule or nodule on the vulva.
• Syringoma: A benign tumor that is believed to originate from sweat glands. It usually appears as a small, firm nodule on the vulva.

These tumors are considered obsolete because they are rare and have been largely replaced by more common types of vulvar neoplasms, such as squamous cell carcinoma and basal cell carcinoma [10][11].

Characteristics

• Trichoepithelioma: Typically presents as a small, solitary papule or nodule on the vulva.
• Syringoma: Usually appears as a small, firm nodule on the vulva.

References

[1] NCI - Term Hierarchy. GTR; MeSH; [10] Some tumors, such as adenoid cystic carcinoma, may ... [11] Carcinomas of sweat gland origin show lines of differentiation and possibly a histogenesis that are similar to their counterparts in the non-vulvar skin.

Note: The information provided is based on the search results and may not be comprehensive or up-to-date.

Based on the provided context, it appears that there are various types of vulvar tumors, including those of skin appendage origin. Here are some signs and symptoms associated with these conditions:

• Vulval melanoma: This rare type of cancer presents as a vulval lesion, which may or may not be pigmented [3]. It can also develop in the background of melanocytic nevi.
• Vulvar Paget's disease (VPD): A rare form of cutaneous adenocarcinoma that affects the vulva. Symptoms include an asymptomatic mass, sometimes accompanied by systemic symptoms such as fatigue, fever, and night sweats [7].
• Squamous cell carcinoma: The most common type of vulvar cancer, which can present with various signs and symptoms, including itching, burning, or bleeding on the vulva that does not go away [13].

Some general signs and symptoms associated with vulvar tumors include:

• Itching, burning, or bleeding on the vulva that does not go away
• Changes in the color of the skin of the vulva, so that it looks redder or whiter than is normal for you
• Skin changes in the vulva, including what looks like a rash or warts
• A red, pink or white bump (or bumps) with a rough or scaly surface on the vulva
• Burning, pain or itching in the genital area
• Pain when you urinate
• Bleeding and discharge when you are not having a menstrual period
• A sore on the vulva that does not heal for a month

It's essential to note that these symptoms can vary from woman to woman, and some women may experience no symptoms at all [11].

References:

[3] by J Morrison · 2024 · Cited by 6 — Vulval melanoma is rare, presents as a vulval lesion, which may or not be pigmented and may or may not develop in the background of melanocytic nevi. [7] Patients usually present with an asymptomatic mass, sometimes with systemic symptoms such as fatigue, fever, and night sweats. Generalized lymphadenopathy, ... [11] Most women with vulvar intraepithelial neoplasia (VIN) have no symptoms at all. When a woman with VIN does have a symptom, it is most often itching that does not go away or get better. [13] Itching, burning, or bleeding on the vulva that does not go away. Changes in the color of the skin of the vulva, so that it looks redder or whiter than is normal for you. Skin changes in the vulva, including what looks like a rash or warts.

Diagnostic Tests for Obsolete Vulvar Tumors of Skin Appendage Origin

The diagnosis of obsolete vulvar tumors of skin appendage origin, such as Extramammary Paget's Disease (EMPD) and Vulvar Intraepithelial Neoplasia (VIN), requires a combination of clinical evaluation, imaging studies, and histopathological examination.

• Clinical Evaluation: A thorough medical history and physical examination are essential in identifying the symptoms and characteristics of the vulvar tumor. The doctor may perform a colposcopy to examine the vulva and vagina using a special microscope.
  • [2] Colposcopy facilitates delineation of lesion margins, and use of a micromanipulator or a hand piece with a depth gauge allows application of high-power density ...
• Imaging Studies: Imaging studies such as ultrasound, MRI, or CT scans may be used to evaluate the extent of the tumor and rule out any metastasis.
  • [4] Suspicious growths require diagnostic biopsy and in case of cancer diagnosis surgical ablation is mandatory.
• Histopathological Examination: A biopsy is essential for a definitive diagnosis. The biopsy sample is examined under a microscope by a pathologist to identify the type of tumor cells and their behavior.
  • [1] For definite diagnosis of a vulvar lesion, a biopsy is needed. However, in practice, the decision to perform a biopsy is often delayed due to a ...
• Vulvar Mapping: In some cases, vulvar mapping may be performed to identify the extent of the tumor and plan the surgical treatment.
  • [8] To diagnose EMPD at least one skin biopsy is required, however in a large Dutch cohort vulvar mapping was performed in 42.5 % of all patients 87 (Figure 2).

Additional Diagnostic Tests

Other diagnostic tests that may be used to evaluate the vulvar tumor include:

• Toluidine Blue Dye Test: A dye test may be used to identify areas of abnormal skin that need to be biopsied.
  • [10] Less often, the doctor might wipe the vulva with a dye (called toluidine blue) to find areas of abnormal vulvar skin to biopsy. This dye causes skin with certain diseases -- including VIN and vulvar cancer -- to turn blue.

References

[1] For definite diagnosis of a vulvar lesion, a biopsy is needed. However, in practice, the decision to perform a biopsy is often delayed due to a ...

[2] Colposcopy facilitates delineation of lesion margins, and use of a micromanipulator or a hand piece with a depth gauge allows application of high-power density ...

[4] Suspicious growths require diagnostic biopsy and in case of cancer diagnosis surgical ablation is mandatory.

[8] To diagnose EMPD at least one skin biopsy is required, however in a large Dutch cohort vulvar mapping was performed in 42.5 % of all patients 87 (Figure 2).

[10] Less often, the doctor might wipe the vulva with a dye (called toluidine blue) to find areas of abnormal vulvar skin to biopsy. This dye causes skin with certain diseases -- including VIN and vulvar cancer -- to turn blue.

Based on the provided context, it appears that there are several treatment options available for vulvar tumors of skin appendage origin.

• Topical imiquimod cream has been reported as an effective treatment option for vulvar HSIL (VIN usual type) when occult invasion is not a concern [1]. This treatment can be used in combination with excision, laser ablation, or other local approaches.
• Alternative treatment options include topical 5% imiquimod cream, topical 5-fluorouracil, and photodynamic therapy. These treatments may be considered when surgery is contraindicated [2].
• Due to the relatively high number of KIT mutations in vulvovaginal melanoma, tyrosine kinase inhibitors may be a treatment option in the future [3].

It's worth noting that relapse occurs in over 30% of patients, and medical treatment, especially imiquimod, can be an alternative treatment option in the management of vulvar tumors [4]. Research is ongoing to investigate new treatments for preventing vulvar cancers, including investigations into oncogenes, tumor suppressor genes, drug treatments, surgery, radiation therapy, and immunotherapy [5].

In terms of specific drug treatments, topical chemotherapy with imiquimod 5% has been reported as effective provided invasive carcinoma has been excluded [6]. Histologic evaluation of the specimen is crucial to ensure that invasive carcinoma has not occurred.

Overall, while there are several treatment options available for vulvar tumors of skin appendage origin, it's essential to consider individual circumstances and preferences when determining the best course of treatment.

Based on the provided context, it appears that you are looking for information on the differential diagnosis of an obsolete vulvar tumor of skin appendage origin.

The differential diagnoses for such a tumor include:

• Adenocarcinoma of skin appendage origin [5][6]
• Metastatic adenocarcinoma [5][6]

It's worth noting that these conditions are relatively rare and may require further investigation to confirm the diagnosis. A thorough examination and histological analysis would be necessary to rule out other potential causes.

Additionally, it's mentioned in point 9 that condyloma should display viral cytopathic effect (koilocytosis) of the upper epithelial layers, which is a key distinguishing feature from other vulvar lesions.

According to point 10, vulvar cancer represents 0.3% of all new cancer cases annually at a rate of 2.6 per 100,000 women per year in the United States, with squamous cell carcinoma (SCC) accounting for most vulvar cancers.

In terms of recent developments, point 11 mentions that vulvar squamous neoplasms – intraepithelial and invasive – are now classified by their aetiological relationship with human papillomavirus, which may be relevant to the differential diagnosis of skin appendage origin tumors.

Overall, while there is limited information on obsolete vulvar tumors of skin appendage origin in the provided context, it appears that adenocarcinoma of skin appendage origin and metastatic adenocarcinoma are potential differential diagnoses. Further investigation would be necessary to confirm the diagnosis and rule out other potential causes.