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1304 Is vulvovaginal lichen planus associated with vaginal carcinoma?
  1. Ana Rita Alves1,2,
  2. Rita Sousa1,
  3. Sofia Raposo1,
  4. Sofia Pereira1 and
  5. Paulo Correia1
  1. 1Portuguese Institute of Oncology of Coimbra, Coimbra, Portugal
  2. 2Centro Hospitalar de Leiria, Leiria, Portugal

Abstract

Introduction/Background Vulvar lichen planus (LP) is a chronic inflammatory disorder that affects mucocutaneous tissues, including vulva, vagina and other non-genital regions, such as oral mucosa, skin and esophagus.

The etiology of this condition is still not fully understood, but it is considered to be an autoimmune disease.

Vaginal cancer is a rare type of cancer, accounting for 1–2% of all gynecologic cancers. The most common histologic type of vaginal cancer is the squamous cell carcinoma.

Lichen planus appears to have an inherent oncological potential, however the relationship between lichen planus and squamous cell malignancy is uncertain.

Results A 63-year-old woman was initially referred for symptoms of dysphagia and heartburn. During the investigation she performed some endoscopies examinations that showed severe strictures and linear ulcers in the esophagus until histological examination revealed esophageal lichen planus.

On physical examination, she presented skin lesions and lip commissure lesions. She also had suffered from vulval pruritus for a long time and reported the emergence of a vulvar lesion.

The gynecological examination revealed an exophytic tumor formation, exteriorizing through the vulva, friable and with necrosis, infiltrating the entire posterior wall of the vagina, extending to the lateral walls. Biopsy showed an invasive squamous carcinoma non-HPV-associated.

Conclusion This case highlights the need to perform vulval examination in patients with symptoms or with a history of muco-cutaneous lichen planus and if relevant consider referral to gynecology for biopsy and management.

Malignant transformation in women with vulvo-vaginal lichen planus with treatment and under surveillance seems to be low, so follow-up appears to be crucial to prevent future malignancies.

Disclosures The authors declare that they have no conflict of interest.

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