Microinvasive carcinoma of the vulva: a clinicopathologic evaluation.

Two types of neoplasms described as superficially invasive or microinvasive carcinoma of the vulva were identified. One type, which can be treated by conservative surgery, is commonly associated with extensive overlying intraepithelial neoplasia. Usually 1 focus of microinvasion, but occasionally more invades less than 2 mm into the underlying stroma. The infiltrating cells comprise 1 or more isolated cords, and confluency is never present. The second and less common form tends to metastasize early to lymph nodes and should be treated by a radical approach. This type is seldom associated with overlying intraepithelial neoplasia. It tends to be poorly differentiated and is confluent. In this series, 2 of 3 patients with confluent microinvasion had metastases to the lymph nodes, but none of 15 patients with nonconfluent microinvasion developed metastases.