9 - Vulval Cancer Flashcards
what age is most common for diagnosis of vulval cancer?
age 74
75% of diagnoses > 60 years
4 main symptoms of VC?
pain
itch
bleeding
lump/ulcer
4 RFs of VC?
Intraepithelial neoplasia/ cancer at other lower genital tract site
Lichen sclerosus
Smoking
Immunosuppression
VIN?
Vulva intra-epithelial Neoplasia
when is VIN likely?
when the cancer is HPV related
HPV related VC - who is usually affected and what do they have a history of?
younger women with history of VIN and immunosuppression
when is differentiated VIN likely?
when VC is non-HPV related
non-HPV related VC - who is usually affected and what do they have a history of?
older women with history of lichen sclerosus and presents as cancer at first diagnosis
describe stage 1 VC in terms of size, nodes involved and survival rates?
<2cm
no nodes
97% survival
describe stage 2 VC in terms of size, nodes involved and survival rates?
> 2cm
no nodes
85% survival
describe stage 3 VC in terms of size, nodes involved and survival rates?
local spread
unilateral nodes
46% survival
describe stage 4 VC in terms of size, nodes involved and survival rates?
distant/ advanced local spread
pelvic nodes
50% survival
how is histopathology achieved?
punch/ excisional biopsy
possible inflammatory diagnosis of histopathology?
lichen sclerosus
possible dysplasia diagnosis of histopathology?
VIN
possible malignant diagnosis of histopathology?
squamous cell carcinoma
definition of VIN?
Abnormal proliferation of squamous epithelium; can progress to carcinoma
usual type of VIN?
Associated with HPV infection
Low grade (VIN 1) or high grade (VIN 2 and 3)
differentiated type of VIN?
In older women
not HPV related
always high grade
type of cell present in classical VIN histology slide?
Koilocyte
staging used for VC?
FIGO staging
what is important to measure for squamous cell carcinoma?
depth of the invasion
what can be seen in squamous cell carcinoma histology slides?
keratinisation
3 types of surgery to treat vulva cancer?
individualised surgery
local excision
unilateral/ bilateral node dissection
other treatments for VC?
radiotherapy
chemotherapy
what does groin node dissection involve?
inguinal and upper femoral nodes
3 aspects of significant morbidity associated with groin node dissection?
Wound infection
Lymphocysts
Nerve damage
