Gynecology / Women's Health Expert Forum
VIN 4, Round 2
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This forum is for questions and support regarding gynecology issues such as: Cervical Disorders, Colposcopy, Cramps, Cystitis, Fallopian Tube Disorders, Menstruation, Ovarian Disorders, PAP Test, Pelvic Exam, PID, PMS, Surgery, Tests, Ultrasound, Uterine Disorders, Vaginal Disorders.

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VIN 4, Round 2

Hi Dr. Brown.  First off, hello and I hope you and your family are well. You probably don't remember me, but we chatted several times 4 or so years ago when I was experiencing multiple pregnancy loss. My little boy is 3 now, and I appreciate all the great info you gave me. You were so positive and so helpful.

I have a brand new concern.  When my son was a year old, I had laser surgery for VIN 4.  I was assured at the time that is was only precancerous, and my GYN Oncologist joked that if you had to pick a precancerous (or even cancer) below the waist, this was the one to get.  She said it was very low risk for developing further, and highly treatable even if it did.  I had the laser surgery (without a doubt the most painful experience of my entire life).  One year post, I was all clear, no recurrance.  I had my 2 year check up and there were some skin changes.  She performed a biopsy, and the results have come back as stage 4 again!  So I am once again scheduled for laser surgery end of March.  Now, she had told me it can come back, but seemed a bit concerned that it went from 0 to 4 (or high grade) in only a year.  It is a smaller area this time, but I will admit I am worrying.  Is this something that typically reappears like this?  And to grow this quickly (or advance, not sure what the correct term is).  I guess I am worrying that I will have to do this every few years, or that I am one of those that will see this move faster and be more aggressive then is typical.  I guess I am just looking for info.

Thanks Dr. Brown, and again, I hope you and your family are all well.  
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Hi!
So nice to hear from you, and so happy that your little boy is doing well--you must be busy with a three year old on your hands.  VIN does come back.  It is similar to CIN (cervical dysplasia) in that it can be very frustrating to deal with.  Another surgery to clear it up is the right thing to do. Are there any other options besides the laser?  My thought (and I defer to you gyn oncologist on this one) is that if you had a wide local resection the pathologists could check the margins to be sure they were clear. I also read just recently that women with VIN should be checked carefully for vaginal and cervical dysplasia too as a significant number of women have other involved tissues.
Keep on top of the process and you should never have cancer.
Good luck!
Dr B
PS I DO remember!
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Thank you so much.  I will absolutely ask about the margins and the vaginal/cervical dysplasia.  Interesting comment as I did ask about cervical dysplasia and was told there is no relationship.  It does make me wonder if my gyn oncologist is up to date with her information.  I do make sure I have my pap annually, and so far haven't had an abnormal one.  Would cervical dysplasia show up on a pap?  

Anyway, I will bring it up, and as always I truly appreciate the info.  Have a wonderful day!!
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