Vulvar Intraepithelial neoplasia - Diagnostic and therapeutic challenges

The present retrospective study is an institutional experience on the diagnosis and management of vulvar intraepithelial neoplasia (VIN). One hundred and thirteen patients were reviewed. The commonest symptom was pruritus. The majority of lesions were multifocal, located at the non-hairy part of the vulva. Management consisted of laser CO2 treatment, surgical treatment or conventional medical therapy. Relapsing disease was detected in 25% of the treated and 48% of the non-treated group and was significantly higher for the multifocal lesions. Invasive vulvar carcinoma was developed during follow-up in 3.5% of our study group. The present study confirms the diagnostic and therapeutic difficulties in managing VIN. Although the benefits of treatment are obvious, there is no guarantee that invasion will not occur.