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2022-RA-1396-ESGO Pregnancy- related vulvar cancer
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  1. Cristina Aur1,2,
  2. Diana Mocuta1,2 and
  3. Monica Boros3,4
  1. 1Obstetrics-Gynecology, County Clinical Hospital of Oradea, Oradea, Romania
  2. 2Obstetrics Gynecology, University of Oradea, Oradea, Romania
  3. 3Morphopathology, County Clinical Hospital of Oradea, Oradea, Romania
  4. 4Morphological Disciplines, University of Oradea, Oradea, Romania

Abstract

Introduction/Background Vulvar cancer is a malignant disease appeared mostly in postmenopausal women. When the lesion appears prior, during pregnancy or in postpartum, it is a rare condition. Cervical and vulvar neoplasia are now diagnosed more and more during pregnancy and it is wellknown the relation between this neoplasia and Human Papilloma Virus (HPV) infection. The pregnancy outcome in these cases is the aim of our study.

Methodology Vulvar cancer was diagnosed in 284 patients in the last ten years, in our hospital. All the women were tested for HPV. Three cases only were pregnancy-related. The object of our study was the pregnancy outcome.In one of the pregnant patients, CIN grade 3 was also diagnosed.

Results All the patients were HPV positive. In all these patients healthy babies were delivered, all of them by Cesarean section. Vulvar cancer and CIN grade 3 were both diagnosed in a 26 years old second trimester pregnant patient monitored in our department of obstetrics. Her medical history revealed that she had before two babies, the first delivered vaginally and the second by C section. She was diagnosed during her actual pregnancy and treated for vulvar cancer by surgery. Radiotherapy was performed after the delivery by C section of a healthy, at term baby. Conization of the cervix was performed a couple of months later, when grade 3 CIN was diagnosed. The presence of HPV16 confirmed the theory that this viral infection is strongly considered the main factor in the etiology of both neoplastic diseases, vulvar cancer and cervical intraepithelial neoplasia.

Conclusion Pregnancy associated vulvar neoplasia is very rare. The management and long-term outcome for the mother and the baby are difficult to assess, but it is possible to have a normal, successful, at term delivery following the treatment for vulvar neoplasia.

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