Gynae: Vulval Cancer Flashcards
what are the most common types of vulval cancer?
squamous cell carcinoma
(less common are malignant melanomas)
what are the risk factors for vulval cancer?
- Advanced age (particularly over 75 years)
- Immunosuppression
- HPV infection
- Lichen sclerosus - Around 5% of women with lichen sclerosus get vulval cancer
what is vulval intraepithelial neoplasia? (VIN)
premalignant condition affecting the squamous epithelium of the skin that can precede vulval cancer
what is high grade squamous intraepithelial lesion?
type of VIN associated with HPV infection that typically occurs in younger women ages 35-50
what is differentiated VIN?
type of VIN associated with lichen sclerosus and typically occurs in older women (aged 50-60 years)
what is required to diagnose VIN and how is it managed?
biopsy
- Watch and wait with close followup
- Wide local excision (surgery) to remove the lesion
- Imiquimod cream
- Laser ablation
what is required to diagnose VIN and how is it managed?
biopsy
- Watch and wait with close followup
- Wide local excision (surgery) to remove the lesion
- Imiquimod cream
- Laser ablation
how does vulval cancer present?
may be incidental finding - on catheterisation of older woman
may have symptoms
- Vulval lump
- Ulceration
- Bleeding
- Pain
- Itching
- Lymphadenopathy in the groin
vulval cancer most frequently affects the labia majora and give what appearance?
- irregular mass
- fungating lesion
- ulceration
- bleeding
how is vulval cancer managed?
- referral on 2ww
- biopsy of lesion, sentinel node biopsy for lymph node spread and staging CT
- management is stage dependent
- Wide local excision to remove the cancer
- Groin lymph node dissection
- Chemotherapy
- Radiotherapy
overview of incidence, deaths, survival 10 or more years and preventable
