Vulvar intraepithelial neoplasia (VIN) is a precancerous type of squamous lesion that grows on the vulva. VIN grades 1, 2, and 3 are based on how thick the growth is in comparison with the surrounding, healthy, vulvar skin.
Vulvar intraepithelial neoplasia 2 is a grade of vulvar intraepithelial neoplasia (VIN). VIN 2 and VIN 3 are both considered high grade and have a higher risk of developing into cancer than low grade VIN. However, treatment can resolve VIN 2 and stop cancer from developing.
Surgery to remove the abnormal growth is the most common treatment. Additional options include cream, ointment, or laser removal.
This article takes a closer look at VIN 2, including how it’s defined, what causes it, and how it’s treated.
Vulvar intraepithelial neoplasia is a type of squamous lesion that grows on the vulva. It’s sometimes called a precancer because it can progress to squamous cell carcinoma.
There are grades of VIN. The grades are based on how thick the growth is in comparison with the surrounding, healthy, vulvar skin. VIN 2 means that the abnormal growth has a depth of less than two-thirds of the top layer of vulvar skin.
Not everyone has symptoms of VIN 2. It’s sometimes diagnosed because it’s found during routine pelvic examinations. When symptoms do occur, they can include:
- pain in and surrounding the vulva
- changes to the skin of and around the vulva
- itching in the vulvar area
- painful sex
Is vulvar intraepithelial neoplasia 2 a precursor to cancer?
VIN of any grade can progress to cancer. It’s more likely when the grade is higher. This means that VIN 2 is more likely to progress to cancer than VIN 1, sometimes just called VIN. However, it doesn’t mean that all cases of VIN 2 progress to cancer. Additionally, when VIN 2 is treated, it can be resolved completely.
The cause of VIN 2 is unclear. Researchers know that VIN is abnormal cell growth in the vulva, but they don’t know what causes these cells to grow.
Known risk factors for VIN 2 include:
The first step to diagnosing VIN 2 is typically a pelvic exam. During this exam, a doctor will examine your vulva, vagina, cervix, and anus to check for any abnormalities. You might also have a pap test and an HPV test.
If you have symptoms, such as itching or painful sex, your doctor could order a colposcopy. A colposcopy is an imaging test that will let doctors see the inside of the cervix, vagina, and vulva. It can help rule out other conditions.
If VIN 2 is suspected after this testing, you’ll have a biopsy of the abnormal growth. The area will be numbed, and a small tissue sample will be removed. The sample is sent to a lab where it can be examined closely to see if it’s made of squamous cells. This can confirm a diagnosis of VIN and can allow your doctor to grade it.
VIN 2 is typically treated with surgery to remove the abnormal growth. This is done to ensure that the growth never progresses and that cancer never develops. The surgery you’ll have is called a vulvectomy.
There are a few different types of vulvectomy. The exact type you’ll have depends on how much tissue the surgeon needs to remove to ensure that the entire abnormal growth has been removed. In VIN 2, a type of vulvectomy called “skinning,” which involves only removing the top layer of the vulva, is often an option.
Recovery from a vulvectomy takes about 2 to 3 weeks. At that point, you’ll likely be able to return to work and do many other daily activities. However, it typically takes about 6 to 8 weeks before it’s safe to use your genitals for sexual activity. Your doctor will let you know when it’s safe for you.
Surgeries aren’t the only treatment option for VIN 2. Sometimes, laser treatments to burn away the growth are used. Topical creams and ointments that can activate your immune system and cause it to slowly destroy the growth over several months are an additional option.
VIN 2 can be completely resolved and cured with surgery and other treatments. However, your doctor will want to continue monitoring you once your treatment is complete.
VIN of all grades, including VIN 2, can grow back. To ensure you remain free of VIN 2, you might have checkups every few months for a year or two after your treatment. You might need fewer checkups as time goes on.
VIN is the growth of abnormal cells on the vulva. It’s not cancer, but it can become cancer.
VIN is graded by the thickness of its growth in comparison with the healthy skin surrounding it. VIN 2 means that the growth has a depth of less than two-thirds of the depth of the top vulvar skin layer.
VIN 2 has a higher risk of progressing to cancer than VIN 1, sometimes just called VIN.
Surgery is typically done to remove the growth and ensure that cancer develops. Surgery to treat VIN 2 is called vulvectomy. Other treatment options include laser and cream removal of the abnormal growth.
Treatment can resolve VIN 2, although there’s a chance it may grow back. Your doctor may recommend checkups following treatment to screen for recurrence.