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Introduction <p>The HPV associated premalignant and malignant diseases can sometimes be multifocal and involve multiple sites. This may be difficult to suspect and diagnose otherwise. Colposcopy has a critical role in the early detection and differentiation of such lesions.</p> Methods <p>In this series we describe the role of HPV DNA testing and genotyping in confirming and classifying the lesions in less common gynecological sites of vagina and vulva. In all the 4 cases the HPV DNA titre on Hybrid capture 2 technique was significantly high and HPV 16 was the commonest genotype assocoiated with both vaginal or vulval cancer. There was a history for hysterectomy for the cervical intraepithelial lesion in 3 of these cases, after which these patients were lost to follow-up. This reiterates the importance of continued screening of such patients even after hysterectomy.</p> Conclusion <p>Cytology is not a sensitive method of early detection of vaginal intraepithelial neoplasia and thus not a good tool for surveillance. HPV testing is the better method. Vaginal and vulval colposcopy is helpful in identifying and differentiating premalignant and malignant lesions and requires experience. Treatment of both intraepithelial neoplasia and invasive disease can be surgically or through ablation or radiation.</p>

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Colposcopy in the Diagnosis of Multisite HPV-Associated Rare Neoplasia: A Series of Cases

  • 期刊论文

  • 发表日期：

    2025年5月9日

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  • Priyanka Singh,
  • Manisha Gupta

摘要

Introduction

The HPV associated premalignant and malignant diseases can sometimes be multifocal and involve multiple sites. This may be difficult to suspect and diagnose otherwise. Colposcopy has a critical role in the early detection and differentiation of such lesions.

Methods

In this series we describe the role of HPV DNA testing and genotyping in confirming and classifying the lesions in less common gynecological sites of vagina and vulva. In all the 4 cases the HPV DNA titre on Hybrid capture 2 technique was significantly high and HPV 16 was the commonest genotype assocoiated with both vaginal or vulval cancer. There was a history for hysterectomy for the cervical intraepithelial lesion in 3 of these cases, after which these patients were lost to follow-up. This reiterates the importance of continued screening of such patients even after hysterectomy.

Conclusion

Cytology is not a sensitive method of early detection of vaginal intraepithelial neoplasia and thus not a good tool for surveillance. HPV testing is the better method. Vaginal and vulval colposcopy is helpful in identifying and differentiating premalignant and malignant lesions and requires experience. Treatment of both intraepithelial neoplasia and invasive disease can be surgically or through ablation or radiation.