RT Book, Section A1 Usatine, Richard P. A1 Smith, Mindy A. A1 Chumley, Heidi S. A1 Mayeaux, E.J. SR Print(0) ID 57675568 T1 Chapter 87. Vulvar Intraepithelial Neoplasia T2 The Color Atlas of Family Medicine, 2e YR 2013 FD 2013 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-176964-8 LK accessmedicine.mhmedical.com/content.aspx?aid=57675568 RD 2024/03/29 AB A 63-year-old black woman presents with a “knot” on her labia majora (Figures 87-1 and 87-2). She is a smoker but is otherwise healthy. The lesion is occasionally pruritic but is generally asymptomatic. She found it approximately 6 months ago, and it has been slowly increasing in size. There is no significant family history of cancer. On physical exam she is found to have exophytic condyloma acuminata around the introitus and a growth labelled vulvar intraepithelial neoplasia (VIN) that the patient called a “knot.” A 3-mm punch biopsy is performed and demonstrates VIN III. The patient is referred to gynecologic oncology.