Differentiated vulvar intraepithelial neoplasia (dVIN)
This article was last reviewed and updated on October 31, 2018
by Emily Goebel, MD FRCPC
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 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.
Differentiated vulvar intraepithelial neoplasia (dVIN) is a precursor disease that develops in the vulva. dVIN is called a precursor 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 move out of 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, which is a benign, inflammatory skin condition. Unlike other precursor lesions in the vulva, dVIN is not associated with human papillomavirus (HPV).
The first diagnosis of dVIN is usually made on a biopsy and a larger surgical procedure (for example, an excision or vulvectomy) is later performed to remove the disease and look for abnormal cells in the dermis (squamous cell carcinoma).
Excision or resection specimens 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.