Atrophic vulvar lichen sclerosus evolving to an epidermoid carcinoma: about an uncommon case

Abstract

Malignant tumors of the vulva are usually budding, ulcerated, or infiltrating. The fear of cancer must always be in mind, in front of any vulvar lesion. Therefore, do not hesitate to make biopsies of any lesion of the vulva to confirm or deny a cancer. We hereby report the uncommon case of a postmenopausal 68-old-patient followed for an atrophic vulvar lichen sclerosus which eventually transformed into an epidermoid carcinoma of the vulva. The indication for right hemivulvectomy with sentinel lymph node procedure was retained. Vulvar cancer takes a variety of aspects. It is therefore necessary to always have it in mind and to make a biopsy before any suspicious lesion. Since the atrophic vulvar lichen sclerosus of the vulva is a pre-cancerous lesion, we believe that its follow-up must be strict and a second biopsy must be performed before any worsening of the lesions. Finally, the procedure of the sentinel lymph node is of great interest when we know the morbidity of the inguinal region dissections but also the slow learning curve of surgical techniques of vulvar cancer.

Keywords

• vulvar lichen sclerosus
• epidermoid cancer
• sentinel-lymph node