case_images: PMC8193986_01
case_images: Microscopic pattern of verrucous carcinoma of the vulva. (A) Low-power view of verrucous carcinoma of the vulva showing nests and islands of well- differentiated squamous epithelial cells embedded in a dense stroma. (B) High-power view showing extremely well- differentiated squamous epithelial cells.
case_images: fonc-11-598594-g001.jpg
case_images: PMC8193986_01_fonc-11-598594-g001.jpg
case_images: f1
case_images: At this time, a re-examination of the pathology in 2017 revealed that the pathology at that time also suggested verrucous carcinoma ( Figure 1 ).
case_images: Immunohistochemical testing of tissue from the first biopsy. Immunohistochemical testing of tissue from the first biopsy reported strong membranous staining of PD-L1 in more than 90% of tumor cells and 25% of tumor associated immune cells.
case_images: fonc-11-598594-g002.jpg
case_images: PMC8193986_01_fonc-11-598594-g002.jpg
case_images: f2
case_images: Immunohistochemical testing of tissue from the first biopsy reported a PD-L1 overexpression ( Figure 2 ).
case_images: Positron emission tomography/computed tomography (PET/CT) imaging. PET/CT scan showed that metastatic lymph nodes were smaller and less than before (A-D), and the vulva lesions were smaller than before (E-H). (A, C, E, G) are PET/CT imaging taken in January 2019. (B, D, F, H) are PET/CT imaging taken in October 2019.
case_images: fonc-11-598594-g003.jpg
case_images: PMC8193986_01_fonc-11-598594-g003.jpg
case_images: f3
case_images: In October 2019, after a total of six courses of neoadjuvant chemotherapy and immunotherapy, the PET/CT scan showed that the lesions were smaller than before, metastatic lymph nodes were smaller and less than before ( Figure 3 ).
case_images: Postoperative pathological. Pathological examination revealed a vulva low-grade squamous intraepithelial lesion (LSIL) with negative margin, no residual cancer was found.
case_images: fonc-11-598594-g004.jpg
case_images: PMC8193986_01_fonc-11-598594-g004.jpg
case_images: f4
case_images: Pathological examination of the specimen confirmed a vulva low-grade squamous intraepithelial lesion with negative margin, no residual cancer was found ( Figure 4 ).