Introduction/Background Vaginal intraepithelial neoplasia (VaIN) is considered the precursor lesion of vaginal cancer. Due to its low prevalence (its diagnosis accounts for 0.4% of all premalignant lesions of the lower genital tract) there are few studies in the literature that provide an in-depth understanding of its aetiopathogenesis and natural history. Therefore, it makes clinical management of VaIN a real challenge. Human papillomavirus (HPV) infection has been identified as the causative agent in up to 90% of VaIN cases, with HPV 16 being the most frequent genotype. With these four case reports, we aimed to evaluate the effect of a Coriolus versicolor-based vaginal gel in the management of VaIN lesions.

Methodology Here we present a series of case reports involving four patients between 44 and 64 years old diagnosed with VaIN through cytology, vaginoscopy and/or biopsy. Two out of the four patients were immunocompromised due to previous history of cancer and multiple sclerosis. The patient diagnosed with low-grade VaIN followed a conservative management with the Coriolus versicolor-based vaginal gel alone. The other three patients with high-grade VaIN, were subject to either an excisional treatment or a CO2/Laser vaporization, in combination with the Coriolus versicolor-based vaginal gel for 6 months as an adjuvant treatment. Follow-up cytology, vaginoscopy, biopsy and HPV tests were performed over time for monitoring patients.

Results After 6 months of adjuvant treatment with the Coriolus versicolor-based vaginal gel, all patients showed regression (1 patient) or complete normalization (3 patients) of their lesions in cytology, vaginoscopy, and/or biopsy. Additionally, patients showed negative results for HPV tests.

Conclusion The application of a Coriolus versicolor-based vaginal gel could be useful both, in conservative treatment (patients with LSIL VaIN) and in post-intervention treatment to prevent lesion’s recurrence and aid in HPV clearance, representing a possible clinical advantage approach in this patient population.

Disclosures .