Journal of Minimally Invasive Gynecology (IF 2019/2020: 3.107) 2012 Nov-Dec

Drs Maria Grazia Fallani, Massimiliano Fambrini, Virginia Lozza, Claudia Bianchi, Annalisa Pieralli

The ideal treatment of large multifocal vulvar intraepithelial neoplasia grade 3 (VIN 3) in young patients is still debated.

The goal is to prevent the development of invasive vulvar cancer while preserving normal vulvar anatomy and function.

The authors describe the case of a 37-year-old woman affected by a biopsy-proven VIN 3 involving the entire external genitalia.

A total superficial vulvectomy was carried out in 2 closer sessions by CO(2) laser is used in an excisional way.

Both procedures were performed in an outpatient setting with the patient under local anesthesia and without suturing stitches or skin flaps.

Definitive pathologic analysis confirmed VIN 3 with free margins.

No intraoperative and postoperative complications were documented.

Functional and anatomic outcomes were optimal, and no relapse occurred after 12 months of follow-up.

Use of CO(2) laser total superficial vulvectomy shows promise of a safe and adequate treatment in selected young patients with VIN 3 involving the entire external genitalia.