Carcinoma in situ of the vulva: a review of 31 treated and five untreated cases.

Thirty six patients with carcinoma in situ of the vulva have been followed from two to 23 years. Among 31 patients managed by surgical excision, there were four recurrences of vulvar carcinoma in situ and one patient developed a vulvar carcinoma 17 years later. Four middle-aged and elderly women managed only by biopsy all progressed to invasive vulvar carcinoma in two to eight years; one additional patient progressed to invasion after inadequate primary treatment. These last five cases all represented multifocal lower genital tract neoplasia. Untreated vulvar carcinoma in situ, when seen as part of a multifocal lower genital tract neoplastic process, in middle and later life is likely to progress to invasion.