[Vulvar intraepithelial neoplasia. An issue of gynecologic interest]

The term vulvar intraepithelial neoplasia is used to designate squamous proliferative lesions characterized by disorders of cell maturation and nuclear abnormalities at various levels in the vulvar epithelium. Due to the fact that 40-50% of the patients are asymptomatic, the standard of diagnosis remains visualization and biopsy of all suspect vulvar lesions. The risk of VIN evolving into an invasive carcinoma is not accurately known but the data from literature suggests that 20-30% of these patients will consecutively develop an invasive squamous cell carcinoma of the vulva. Choosing the best therapeutic approach for these patients is challenging because of the extent of the lesions and, frequently, their multifocal nature. Increasing incidence among younger women justify a more conservative approach, the aim of the treatment remains however the prevention of progression to invasive cancer.