Cancer de vulva.

Question 1

Edad de aparicion mas frecuente de Ca de vulva

Answer 1

65-75 años.

Question 2

Clinica y localizacion mas frecuente de Ca de vulva.

Answer 2

Prurito vulvar, labios mayores.

Question 3

Diagnostico de eleccion Ca de vulva.

Answer 3

Biopsia

Question 4

Tratamiento de eleccion Ca de vulva.

Answer 4

Cirugia +/- radioterapia.
1a. Exeresis local amplia.
1b Lesiones laterales: hemivulvectomia lateral+biopsia selectiva de ganglio centinela. Lesiones centrales: Hemivulvectomia anterior o post+ganglio centinela o linfadenectomia lateral.
II-III. Vulvectomia radical y linfadenectomia inguinal bilateral con RT posterior.
IV. Exenteracion pelvica.

Question 5

Variedad mas frecuente de Ca de vulva

Answer 5

Epidermoide/ Ca escamoso

Question 6

Factores de riesgo Ca de vulva.

Answer 6

tabaco, inmunosupresion, Ca de cervix, VPH, distrofia vulvar con atipias.

Question 7

Se extiende por:

Answer 7

Continuidad y via linfatica.

Question 8

Factores pronosticos mas importantes

Answer 8

Estadio clinico y afectacion ganglionar.

Question 9

Estadificacion Ca de vulva. Estadio I

Answer 9

Lesion confinada a vulva o perine sin metastasis ganglionares. Ia <2cm <1mm de invasion a estroma.
Ib. >2cm >1mm de invasion de estroma.

Question 10

Estadio II Ca de vulva.

Answer 10

Tumor de cualquier tamaño con afeccion de tercio inferior de uretra, vagina o ano, sin metastasis ganglionares.

Question 11

Estadio III Ca de vulva.

Answer 11

Tumor de cualquier tamaño con afeccion de tercio inferior de uretra, vagina o ano, CON METASTASIS GANGLIONARES.

Question 12

Estadio IV ca de vulva

Answer 12

Invade 2/3 superiores de uretra, vagina o estructuras superiores.

Question 13

A 79 year old woman, gravidity 3 parity 3, was admitted to hospital complaining of vulvar burning. Her fammily history did not reveal malignancies in first degree relatives, and her past medical history was unremarkable. At gynecologic examination the vagina, cervix and uterus appeared normal, whereas an ulcerated area (maximum diameter 7 cm) involving the clitoris and both the right and left majora and mminora labia was documented. Inguinal lymphadenopathies were bilaterally palpable. Biopsy of the lesion documented a well differentiated vulvar squamous cell carcinoma. Indicate the correct treatment for this patient.

Answer 13

Radical vulvectomy and bilateral inguinofemoral lymphadenectomy.