CARCINOMA OF VULVA. LEUKOPLAKIA
An 80 year old woman presented with sore white patches which had been present for several years in the skin of the vulva. A larger ulcerated area had been present for 2 months. A vulvectomy was performed.
The vulva has been mounted to display the external surface. Inferior to the clitoris, on the medial aspect of the right labium minus, there is a thickened ulcerated area 2 cm in diameter which has been infiltrated by tumour. A separate pale tumour nodule 12 x 7 mm in diameter is seen on the surface of the left labium minus. Posteriorly, the skin of the vestibule and labia minora is pale, thickened and smoother than normal. These changes extend into the postero-medial parts of the adjacent labia majora. This is an example of squamous cell carcinoma of the vulva associated with vulval leukoplakia.
Leukoplakia is a clinical term which simply means thickened or atrophic white patches in vulvar skin or in the mouth. A number of unrelated conditions may present in this way. In the vulva, these include carcinoma in situ, chronic dermatitis, psoriasis, and a chronic disorder of unknown aetiology known as vulval dystrophy. There are 2 different forms of vulval dystrophy: (i) atrophic vulval dystrophy (formerly called lichen sclerosis et atrophicus), in which the skin is atrophic; (ii) hypertrophic vulval dystrophy, in which the skin is thickened.