Gyne malignancy vulvar Flashcards
Majority of vulvar cancers are (90%)
Skin - squamous cell
Often a second primary malignancy elsewhere…
cervix/anus
Type 1 vulvar cancer often
HPV-related
- smoking
- immunocompromise
Type 2 vulvar cancer
Chronic disease
- Lichen sclerosis
- other dystrophies
How do you screen for vulvar cancer
colposcopy for women with chronic dystrophies
Warning symptoms of vulvar disease
itching/burning/irregular bleeding
- lesion, groin pain, swelling, bowel/bladder
diagnostic test for vulvar lesion
- Skin biopsy - Keyes punch
NOT a PAP smear
Roles of surgical management
- stage
- treat
- neoadjuvant chemorad for locally advanced disease
vulvar cancer often metastasized to
GROIn nodes
When depth of invastion increases > 1mm then
risk of node mets also goes up exponentially
5-year survival of vulvar cancer highly dependent on
Stage
-
Long-term complications of vulvar cancer include
- lymphedema
- rad sequelae
- sexual dysfunction/body image
Vulvar cancer FIGO staging 1
90% survival in 5 year, drops by half in stage 3 with lymph node involvement
Primary treatment for cervical cancer
1- radical hysterectomy/nodes OR
2- chemoradiation if advanced
Primary treatment for endometrial cancer
1- hysterectomy/BSO/surgical Staging +/- adjuvant radiation
