Histopathological spectrum of vulvar lesions: A 6-year retrospective study

Objectives: The objective of the study is to characterize the histomorphological spectrum of vulvar lesions diagnosed over a 6-year period at a tertiary care center. Materials and Methods: This retrospective study included all consecutive vulvar biopsy specimens received in the Department of Pathology, tertiary care center in western part of India, over a 6-year period from 1 January 2019 to 31 December 2024. Lesions were classified according to the World Health Organization Classification of Tumours of Female Reproductive Organs, 5 th edition (2020). Statistical analysis: Data were analyzed using descriptive statistics. Results were presented as frequencies and percentages for categorical variables, while continuous variables were summarized using median and range. Results: A total of 47 vulvar biopsy specimens were examined. Patient age ranged from 26 to 75 years, with a median age of 50 years. Non-neoplastic lesions accounted for 16 cases (34.04%), comprising diagnoses such as hidradenitis suppurativa, epidermal inclusion cyst, and lichen planus. Neoplastic lesions were identified in 31 cases (65.96%), which included five benign neoplasms (10.64%), six premalignant lesions (12.77%) (of total specimens, n = 47), and 20 malignant cases (42.55%). SCC was the most prevalent malignant diagnosis, accounting for 16 cases (80% of malignant lesions); of these, three cases (18.75%) demonstrated p16 positivity, indicating Human papillomavirus (HPV) association. Additional malignant entities included Paget’s disease of the vulva and basal cell carcinoma. Conclusions: Neoplastic lesions, particularly malignant ones, were more prevalent than non-neoplastic lesions in this cohort, which may reflect preferential histopathological sampling of clinically suspicious lesions. These findings differ from those reported in comparable Indian studies, underscoring the impact of sampling practices on the perceived spectrum of vulvar pathology.