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. Author manuscript; available in PMC: 2023 Feb 1.
Published in final edited form as: Mod Pathol. 2021 Oct 14;35(2):274–282. doi: 10.1038/s41379-021-00942-3

Figure 4 – Clonal evolution of HPV-independent vulvovaginal squamous cell carcinomas.

Figure 4 –

(A) Alluvial graph showing the distribution of the three genomic alterations in vulvovaginal squamous cell carcinomas with the highest cancer cell fractions. All HPV-independent vulvovaginal squamous cell carcinomas have truncal alterations in a combination of TP53, TERT and NOTCH1 genes and any of these genes can have the highest cancer cell fraction in the tumors. (B-C) Phylogenetic reconstruction of the tumor evolution in two cases of metastatic/recurrent vulvovaginal squamous cell carcinomas.