Vulvar Bazal Hücreli Karsinom: Dört Olguluk Bir Seri ve Narratif Derleme

Abstract

Özet Amaç: Vulvar bazal hücreli karsinomlar, oldukça nadir olan vulvar malignitelerin %5’inden azını oluşturan tümörlerdir. Klinik olarak yavaş ilerleyen ve çoğunlukla ülseratif ya da vejetatif lezyonlar şeklinde ortaya çıkan bu tümörler benign dermatozlarla ve vulvanın diğer maligniteleriyle kolaylıkla karışabilmekte ve bu nedenle klinik yönetim açısından gecikmeler yaşanabilmektedir. Histopatolojik değerlendirme sonucunda vulvar bazal hücreli karsinom tanısı alan hastalarda her ne kadar metastaz ve rekürrens riski düşük olsa da uygun cerrahi yaklaşım ile yönetimin planlanması bu risklerin minimalize edilmesi açısından önemli bir rol oynamaktadır. Bu çalışmanın amacı, merkezimizde tanı alan dört vulvar bazal hücreli karsinom olgusunun klinik yönetimini ve kısa dönem sonuçlarını literatür verileri ile karşılaştırmalı olarak ele almak ve oldukça nadir görülen bu vulvar malignite alt tipine yönelik bir derleme sunmaktır. Olgu Sunumu: Çalışmamızda 2020 – 2024 yılları arasında üçüncü basamak jinekolojik onkoloji merkezimizde vulvar bazal hücreli karsinom tanısı alan dört hasta retrospektif olarak incelenmiştir. Hastaların demografik ve klinikopatolojik özellikleri değerlendirmeye alınarak elde edilen veriler literatür ile karşılaştırmalı olarak yorumlanmıştır. Tartışma ve Sonuç: Hastalarımızın yaş aralığı, lezyon süre ve yerleri, histolojik alt tipleri literatürden elde edilen verileri destekler niteliktedir. Hastaların cerrahi yönetiminin negatif sınırlar ile tamamlanmış olması ve kısa dönem takiplerinde rekürrens ile karşılaşılmamış olması literatürde önerilen yönetimsel esaslarla paralellik göstermektedir. Her ne kadar literatürde tanımlanmış vaka serileri olsa da vulvar bazal hücreli karsinomların yönetimi açısından doğrudan bir standart bulunmamaktadır. Bu nedenle, bu nadir tümörün klinik ve patolojik özelliklerinin daha net ortaya konabilmesi için, çok merkezli ve geniş hasta serilerini içeren çalışmalara gereksinim duyulmakta olup çalışmamız bu amaca yönelik literatüre katkı sağlamaktadır.

Keywords

• Bazal hücreli karsinom
• Jinekolojk cerrahi prosedürler
• Vulvar neoplaziler

Vulvar Basal Cell Carcinoma: A Four-Case Series and Narrative Review

Abstract

Abstract Objective: Vulvar basal cell carcinomas (BCCs) are exceedingly rare tumors, accounting for fewer than 5% of vulvar malignancies. Clinically, they typically present as slowly progressing ulcerative or vegetative lesions that may easily be mistaken for benign dermatoses or other vulvar malignancies, potentially leading to delays in diagnosis and management. Although the risks of metastasis and recurrence are low in patients diagnosed with vulvar BCC based on histopathologic evaluation, determining the appropriate surgical approach plays a critical role in minimizing these risks. This study aims to present the clinical management and short-term outcomes of four cases of vulvar BCC diagnosed at our center, to compare these findings with existing literature, and to provide a concise review of this uncommon vulvar malignancy subtype. Case Series: Four patients diagnosed with vulvar basal cell carcinoma at our tertiary gynecologic oncology center between 2020 and 2024 were retrospectively reviewed. Demographic and clinicopathological characteristics were evaluated, and the findings were interpreted in comparison with published data. Discussion and Conclusion: The age range, lesion duration and localization, and histological subtypes observed in our patients were consistent with previously reported cases in the literature. All patients underwent surgical excision with negative margins, and no recurrences were detected during short-term follow-up, supporting the management principles recommended in existing studies. Although several case series have been published, no universally accepted standard exists for the management of vulvar BCC. Therefore, larger multicenter studies with broader patient cohorts are needed to better elucidate the clinical and pathological features of this rare tumor. Our study contributes to the literature by providing additional data relevant to this objective.

Keywords

• Vulvar Neoplasms
• Carcinoma, Basal Cell
• Gynecologic Surgical Procedures

References

1. Huang J, Chan SC, Fung YC, Pang WS, Mak FY, Lok V, et al. Global incidence, risk factors and trends of vulvar cancer: A country-based analysis of cancer registries. International Journal of Cancer. 2023;153(10):1734-45.
2. Flipo R, Bani MA, Rejaibi S, Talhi N, Sastre-Garau X. Vulvar Basal Cell Carcinoma: Clinical and Histopathologic Features. International Journal of Gynecological Pathology. 2022;41(1):86-92.
3. Choi HY, Roh MS, Park JW. Vulvar Basal Cell Carcinoma in Postmenopausal Women: Two Case Reports. J Menopausal Med. 2023;29(1):40-3.
4. Renati S, Henderson C, Aluko A, Burgin S. Basal cell carcinoma of the vulva: a case report and systematic review of the literature. International Journal of Dermatology. 2019;58(8):892-902.
5. Wang GY, Wang J, Mancianti M-L, Epstein EH. Basal cell carcinomas arise from hair follicle stem cells in Ptch1+/− mice. Cancer cell. 2011;19(1):114-24.
6. Niculet E, Craescu M, Rebegea L, Bobeica C, Nastase F, Lupasteanu G, et al. Basal cell carcinoma: Comprehensive clinical and histopathological aspects, novel imaging tools and therapeutic approaches. Experimental and therapeutic medicine. 2022;23(1):60.
7. Schreuder K, Hollestein L, Nijsten T, Wakkee M, Louwman M. A nationwide study of the incidence and trends of first and multiple basal cell carcinomas in the Netherlands and prediction of future incidence. British Journal of Dermatology. 2022;186(3):476-84.
8. Asuman C, Özlem A, Burçak T. An unusual location of basal cell carcinoma: the clitoris and the vulva. Indian journal of dermatology. 2008;53(4):192-4.

9. Ahnlide I, Zalaudek I, Nilsson F, Bjellerup M, Nielsen K. Preoperative prediction of histopathological outcome in basal cell carcinoma: flat surface and multiple small erosions predict superficial basal cell carcinoma in lighter skin types1111. British Journal of Dermatology. 2016;175(4):751-61.
10. Nasr I, McGrath E, Harwood C, Botting J, Buckley P, Budny P, et al. British Association of Dermatologists guidelines for the management of adults with basal cell carcinoma 2021. British Journal of Dermatology. 2021;185(5):899-920.
11. Zane C, Facchinetti E, Arisi M, Ortel B, Calzavara-Pinton P. Pulsed CO2 laser ablation of superficial basal cell of limbs and trunk: a comparative randomized clinical trial with cryotherapy and surgical ablation. Dermatologic Surgery. 2017;43(7):920-7.
12. Caussade M-C, Aguero R, Donoso F, Alshaikh H, Castro JC, Cardenas C, et al. Vulvar basal cell carcinoma treated with Mohs micrographic surgery: a case series and systematic review. Clinical and Experimental Dermatology. 2025;50(9):1843-7.
13. Bath-Hextall F, Ozolins M, Armstrong SJ, Colver GB, Perkins W, Miller PS, et al. Surgical excision versus imiquimod 5% cream for nodular and superficial basal-cell carcinoma (SINS): a multicentre, non-inferiority, randomised controlled trial. The lancet oncology. 2014;15(1):96-105.
14. Scotti B, Vaccari S, Maltoni L, Robuffo S, Veronesi G, Dika E. Clinic and dermoscopy of genital basal cell carcinomas (gBCCs): a retrospective analysis among 169 patients referred with genital skin neoplasms. Archives of Dermatological Research. 2024;316(6):307.
15. Aminimoghadam S, Marzban Z, Ghaemi M, Azizi S. Vulvar basal cell carcinoma: A case report and literature review. International Journal of Surgery Case Reports. 2023;108:108382.
16. Namuduri RP, Lim TY, Yam PK, Gatsinga R, Lim-Tan SK, Chew SH, et al. Vulvar basal cell carcinoma: clinical features and treatment outcomes from a tertiary care centre. Singapore Medical Journal. 2019;60(9):479.
17. Rudd JC, Li C, Hajiannasab R, Khandalavala J, Sharma P. Diagnosing Basal Cell Carcinoma of the Vulva: A Case Report and Review of the Literature. Cureus. 2021;13(12):e20791.