n South African Journal of Obstetrics and Gynaecology - Vulvar cancer in HIV-positive young women - a treatment challenge : case report

Volume 12, Issue 3
  • ISSN : 0038-2329
  • E-ISSN: 2078-5135



Vulvar carcinoma is rare in the premenopausal age group. Depressed immunity has now been implicated as a predisposing factor in the development of vulvar cancer in young patients, particularly for the progression of VIN to invasive cancer. In the past decade an increasing incidence of vulvar cancer in young immunosuppressed women has been observed. It is important to screen for and detect the disease in the early stages. <br>A 24-year-old woman presented at our oncology clinic with a 1-year history of a fast-growing vulvar lesion involving the labia majora, labia minora, clitoris, anal mucosa and urethra and extending to the left buttock. Bilateral mobile 2 cm lymph nodes were palpable. Histological examination showed the tumour to be an invasive squamous cell carcinoma. The disease was staged as T4N2M0. Owing to low CD4 counts of 218 cells/<SPAN lang=AF style="FONT-FAMILY: Symbol; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-char-type: symbol; mso-symbol-font-family: Symbol"><SPAN style="mso-char-type: symbol; mso-symbol-font: Symbol">m</SPAN></SPAN>l and her poor general condition, palliative radiation therapy according to departmental treatment protocol was offered. The patient was followed up 6, 16 and 28 weeks after radiation therapy, and 70% tumour reduction was observed at 6 weeks, 90% at 16 weeks and complete response at 28 weeks. <br>Vulvar carcinoma related to HIV seems to be sensitive to larger than conventional daily doses of radiation therapy, as we observed in this case. Appropriate treatment guidelines are required, as invasive vulvar cancer related to immune suppression due to AIDS is common in African countries.

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