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Vulvar Cancer in Human Immunodeficiency Virus-Seropositive Premenopausal Women: A Case Series and Review of the Literature

Brown, Jill E. MD, MPH1; Sunborg, Michael J. MD2; Kost, Edward MD2; Cosin, Jonathan A. MD3; Winter, William E. III MD2

Journal of Lower Genital Tract Disease: January 2005 - Volume 9 - Issue 1 - p 7-10
Original Articles

This review describes three cases of human immunodeficiency virus-infected women who were diagnosed with vulvar cancer before age 40 years. A retrospective chart review was performed for three patients who were younger than 40 years of age and who had histologically confirmed invasive squamous cell carcinoma of the vulva diagnosed between 1999 and 2002. Demographic, clinical, and laboratory data were recorded. Three human immunodeficiency virus-seropositive women were diagnosed with invasive squamous cell carcinoma of the vulva, stages IA, IB1, and III. All cases were characterized by extensive surrounding vulvar, vaginal, and cervical intraepithelial neoplasia. CD4 cell counts were 250, 330, and 900 cells/uL. Two patients experienced previous acquired immune deficiency syndrome-defining illnesses: toxoplasmosis and cervical cancer. Vulvar cancer in young human immunodeficiency virus-seropositive women may be associated with other human papillomavirus-related diseases and immunosuppression, as evidenced by low CD4 counts and the presence of antecedent acquired immune deficiency syndrome-defining illnesses.

Three cases of invasive vulvar cancer are described in HIV seropositive women less than 40 years old.

1Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, Washington, DC; 2Department of Obstetrics and Gynecology, Brooke Army Medical Center, Ft. Sam Houston, TX; 3Department of Obstetrics and Gynecology, Washington Hospital Center, Washington, DC

Correspondence to: William E. Winter III, MD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brooke Army Medical Center, 3851 Roger Brooke Drive, Ft. Sam Houston, TX 78234. E-mail:

Reprint requests to: Jill E. Brown, MD, MPH, 5800 Nicholson Lane, No. 605, Rockville, MD 20852.

©2005The American Society for Colposcopy and Cervical Pathology