OnlineMedEd: Gynecology - "Vaginal/Vulvar Cancer"

Question 1

What are the three vulvar/vaginal cancers?

Answer 1

• SCC
• Melanoma
• Paget’s

Question 2

SCC and melanoma both present with __________ lesions.

Answer 2

black and itchy

Question 3

How does Paget’s disease present?

Answer 3

It is a RED and itchy lesion –different from the other two.

Question 4

Typically, ____________ can be treated with wide local resection while the other two vulvar cancers necessitate vulvectomy with lymph node resection.

Answer 4

Paget’s disease

Question 5

In general, how should you approach a vulvar lesion?

Answer 5

• First, look for signs of infection (fever, discharge, recent risky sexual behavior, systemic symptoms). If these are present and the lesion looks like an infection – such as an HSV ulceration, HPV condyloma acuminata, syphilis condyloma lata, etc. –then treat the infection. No biopsy is needed.
• Second, if there are no signs of infection and the lesion looks neoplastic, get a biopsy! This will tell you what it is and then you decide how to treat.