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The absence of high-risk HPV combined with specific p53 and p16INK4a expression patterns points to the HPV-independent pathway as the causative agent for vulvar squamous cell carcinoma and its precursor simplex VIN in a young patient.
Kruse AJ, Bottenberg MJ, Tosserams J, Slangen B, van Marion AM, van Trappen PO. Kruse AJ, et al. Among authors: bottenberg mj. Int J Gynecol Pathol. 2008 Oct;27(4):591-5. doi: 10.1097/PGP.0b013e318178e53b. Int J Gynecol Pathol. 2008. PMID: 18753959