Spectrum of vulvar lesions: a clinicopathologic study of 170 cases

Background: A wide range lesions may occur in the vulvar region. The clinician is often confronted with the challenge to draw a distinction between normal variants, benign entities and a potentially serious pathology. The aim of the present study is to have an insight into the diverse morphologic spectrum of vulvar lesions. Methods: The present retrospective study was carried out by compiling the data from archival records over a period of eight years from January 2005 to December 2012. The vulvar biopsies/vulvectomy specimens were studied for histomorphological features. The lesions were categorized as non neoplastic, neoplastic and inconclusive; neoplastic ones were further divided into benign, malignant and premalignant. Results: The age of the women ranged from 6 to 80 years (mean 38.2±6.4) with the maximum number of patients between 31 to 40 years of age. Most common clinical presentation was itching and white plaque on the vulva (85 cases; 50%). The commonest site of vulval lesions was labia majora (87 cases, 51.18%). Non neoplastic lesions were more common (n = 94; 55.29%) than the neoplastic lesions (n =50; 29.41%). There were 23 (46%) benign lesions while 27 cases (54%) were malignant or premalignant ones. In 26 cases, no definitive histologic diagnosis could be rendered. Conclusion: Early recognition of vulvar lesions and a prompt biopsy diagnosis for all lesions with suspicious changes is of great significance. The term leukoplakia is imprecise and should be replaced by a precise histological description.