Vulva -

Differentiated vulvar intraepithelial neoplasia (dVIN)

This article was last reviewed and updated on October 31, 2018
by Emily Goebel, MD FRCPC

Quick facts:

  • Differentiated vulvar intraepithelial neoplasia (dVIN) is a pre-cancerous condition that develops in the skin of the vulva.

  • Patients diagnosed with differentiated vulvar intraepithelial neoplasia have an increased risk for developing a cancer of the vulva called squamous cell carcinoma.


The normal vulva

The vulva is the external part of the female genital tract.  It forms the opening of the vagina and includes the mons pubis, labia majora, labia minora and clitoris. The vulva is made of skin. The surface of the skin is called the epidermis and is made up of squamous cells. The tissue beneath the epidermis is called the dermis, it contains blood vessels and connective tissue.

What is differentiated vulvar intraepithelial neoplasia (dVIN)?

Differentiated vulvar intraepithelial neoplasia (dVIN) is a pre-cancerous disease that develops in the vulva. dVIN is called a pre-cancerous disease because over time it can turn into a cancer called squamous cell carcinoma.


Unlike squamous cell carcinoma, the abnormal cells in dVIN are found only in the epidermis. If the abnormal cells spread beyond the epidermis and into the dermis below, the diagnosis changes to squamous cell carcinoma. The movement of abnormal cells from the epidermis into the dermis is called invasion.

Differentiated vulvar intraepithelial neoplasia is often associated with another condition called lichen sclerosus. Lichen sclerosus is a non-cancerous inflammatory skin condition. Unlike other pre-cancerous diseases in the vulva, dVIN is not caused by human papillomavirus (HPV).

The first diagnosis of dVIN is usually made after a small sample of tissue is removed in a procedure called a biopsy. A larger surgical procedure (for example, an excision or vulvectomy) may be later performed to remove the disease and look for abnormal cells in the dermis.


Larger tissue samples called excisions or resections are usually sent for pathological examination as a single piece of tissue and the tissue is then divided into multiple sections before being examined under the microscope.


A margin is any tissue that needs to be cut by the surgeon in order to remove the tumour from your body. A margin is considered positive when dVIN is seen at the cut edge of the tissue.

Margins will only be described in your report for dVIN once the entire area of abnormal tissue has been removed in an excision or resection.

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