GTG Guideline for Diagnosis and Management of Vulval Carcinoma 2014 Flashcards
What is the incidence of vulval cancer in UK?
Rare
3.7/100,000
What is an incisional biopsy?
Used for Dx, interface between normal and abnormal epithelium
What is excision biopsy?
Includes all the abnormal epithelium, does not provide tumour free zone of 1cm. Used for VIN low suspicion of invasive carcinoma.
What is radical excision?
Clearance of 1cm after fixation on all aspects of the tumour
What is the risk of developing invasive disease with lichen sclerosis?
4%
Not clear if treatment reduces this risk.
What are the 2 types of VIN and how are they classified?
Differentiated VIN (d-VIN) - associated with lichen scelrosus
Undifferentiated VIN - associated with HPV
Which women should have a 2 WW?
Vulval lump
Vulval bleeding due to ulceration
Which women should have a vulval biopsy?
Any change to the vulval epithelium in PM women
- swelling, polyp, lump, elevation, irregularity, warts.
What is the most common type of vulval cancer?
Squamous cell carcinoma
What are the other types of vulval cancer?
Melanoma
Paget’s disease
Bartholin gland tumour
Adenocarcioma
Basal cell carcinoma
How does vulval cancer spread?
Local invasion
Lymph - inguinal/femoral
Haematogeonuos
FIGO 1a
Size <2cm, stromal invasion ,<1mm
FIGO 1b
Size >2cm or stromal invasion >1mm
FIGO 2
Any size, extension into:
- lower 1/3rd urethra
- lower 1/3rd vagina
- lower 1/3rd anus
Negative nodes
FIGO 3
Extension to upper part of adjacent structure +/- LN