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Verrucous carcinoma is a rare, highly differentiated type of neurontin pills carcinoma of the vulva. It occurs in women in the late reproductive and postmenopausal age groups. Clinic and diagnosis of verrucous carcinoma. The disease may resemble genital warts - seroval-white voluminous spongy masses have clear boundaries, are localized on the labia majora and are accompanied by pain and itching. The tumor invades adjacent tissues but rarely metastasizes. In the advanced stage, it can be fatal.
Treatment of verrucous carcinoma consists of local excision of the tumor within healthy tissue. Radiation therapy is not recommended due to the possibility of neurontin pills transformation of benign cells into malignant ones.
Usually manifests from birth, sometimes in childhood and rarely in adults. Prevalence unknown. Due to clinical similarity to localized nonviform angiokeratoma, misjudgment and misdiagnosis are possible. Etiopathogenesis has not been studied. There is an opinion about somatic mutations of MAP3K3, but family cases have not been described.
At the beginning, the disease is characterized by spots or flat papules and plaques with clear boundaries, irregularly shaped pink-red color, often with a blue tint, ranging in size from 5 mm to 5-8 cm. Over time (several months to years), the elements of the rash thicken to large plaques or nodes with the appearance of hyperkeratosis and massive layers of gray, sometimes brown, on the surface and acquire a rich bluish-red color. A violet-purple rim and small "screenings" in the form of gabapentin flat papules or spots are observed along the periphery.
More often, single rashes are noted, less often multiple, merging into large foci, an eruptive form was reported. The location is almost always unilateral, cases with a linear and serpiginous configuration are described. hips), much less often on the trunk and upper limbs. Casuistic cases of rashes in the area of the mucous membrane of the mouth and penis are described.
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The diagnosis is made on the basis of anamnesis, clinical picture and histological examination, in which multiple dilated large capillaries and venules are found in the papillary layer of the skin, connecting with smaller vessels in the reticular dermis and subcutaneous tissue. Cavernous vascular formations are often observed. Lobular structures are noted in the subcutaneous tissue , fat cells and fibrous tissue. The epidermis is hyperplastic with the phenomena of hyperkeratosis, acanthosis and papillomatosis. Leukocytes, hemosiderin, fibrosis are sometimes found in the upper dermis.
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Dermatoscopically, in early lesions, a pronounced bluish-white hue is observed, similar to a blue-white veil in some areas, indicating hyperkeratosis over the underlying vessels, in later lesions, pronounced hyperkeratosis is detected along with bluish lacunae, indicating vasodilation. In peripheral "screenings" there are dark blue lacunae characteristic of vascular lesions.
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The course is progressive with a slow spread of rashes and their size. Complications in the form of ulceration, bleeding and secondary infection of the bacterial flora are quite common. Spontaneous regression of rashes was not noted. MRI is used to assess the depth of the lesion. The disease is clinically indistinguishable from a limited non-viform angiokeratoma. The differential diagnosis is carried out according to the results of a histological examination, in which angiokeratoma reveals vasodilatation without cell proliferation only in the papillary layer of the dermis, and with hemangioma there is a network of dilated capillaries and cavernous vascular formations throughout the dermis and subcutaneously - fatty tissue.
Classes & Events
Also, the disease should be differentiated from: verrucous epidermal nevus verrucous carcinoma limited lymphangioma serpiginous angioma infantile hemangioma Cobb syndrome. Deep surgical excision is recommended to avoid recurrences. Positive results of laser therapy (dye lasers, Nd-YAG, CO2) have been reported. Capillary hemangioma is a group designation of benign neoplasms, often having a lobular architectonics and built from small blood vessels of the capillary type, as well as many cells belonging to these vessels. There are six types of capillary hemangioma.
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Verrucous capillary hemangioma usually appears in the distal lower extremities of young children in the form of a warty formation, often taken as a wart. In the early stages of development (neonatal period), the tumor is identical to a simple heman gnome in the form of a reddish-cyanotic spot. A tendency to relapse was noted. Under the microscope, this variety differs from the previous ones by the simultaneous presence of cavernous and capillary trunks, as well as acanthosis, papillosis and hyperkeratosis of the epidermis.