Neoplastic Disease of the Vulva and Vagina

Question 1

Pre-invasive neoplastic diseases (3):

Answer 1

Squamous (vulvar intraepithelial neoplasia)

Nonsquamous (Paget disease, melanoma in situ)

Question 2

VIN is associated with what infection?

Answer 2

HPV (80-90% of VIN cases), more often in young women than older women

Question 3

Goal of local excision for VIN:

Answer 3

Disease-free margin of 5-10mm

Question 4

Malignant potential of Paget disease:

Answer 4

• 20% will have coexistent adenocarcinoma (commonly metastasize)
• No concern for mets when adenoCA is not present
• Fatal if it spreads to lymph nodes

Question 5

Most common type of vulvar cancer:

Answer 5

• Squamous cell carcinoma (87%)
• Malignant melanoma (6%)
• Bartholin’s adenocarcinoma (4%)
• Basal cell carcinoma (

Question 6

Most important prognostic factor for SCC survival:

Answer 6

number of positive inguinal lymph nodes