Vulva Flashcards
What is the outer part of the female genitals called?
The vulva.
What does the vulva include?
The opening of the vagina, labia minora, labia majora, and clitoris.
What are the labia majora?
The outer lips of the vulva.
What are the labia minora?
The inner lips of the vulva.
What is the clitoris?
A part of the female genitals located at the top of the vulva.
What is the perineum?
The area between the vulva and the anus.
What is the anus?
The opening at the end of the digestive tract.
What type of malignancy is vulvar cancer?
Vulvar cancer is an uncommon malignancy.
What is the typical age of onset for vulvar cancer?
Vulvar cancer usually occurs in postmenopausal women about 70 years old.
What are some risk factors for vulvar cancer?
Risk factors include chronic diseases of the vulva, smoking, history of genital warts, leukoplakia, immune system deficiency, multiple sexual partners, and sexual intercourse at a young age.
What is the preferred modality for diagnosis and staging of vulvar cancers?
MRI is the preferred modality for diagnosis and staging of vulvar cancers.
Is there any screening for vulvar cancers?
No screening.
What staging system is most commonly used for vulvar cancers?
FIGO Staging.
What is a common presenting symptom of vulvar cancer?
Palpable mass on the Labia Major
What history may be associated with vulvar cancer?
History of pruritus
What persistent symptoms may indicate vulvar cancer?
Itching, burning, or bleeding on the vulva that does not go away.
What changes in skin color may suggest vulvar cancer?
Changes in the color of the skin of the vulva, so that it looks redder or whiter than is normal for you.
What skin changes may be observed in vulvar cancer?
Skin changes in the vulva, including what looks like a rash or warts.
What is the most common type of vulvar cancer?
Squamous Cell Carcinoma
90% of vulvar cancer cases are Squamous Cell Carcinoma.
What is the most common site for vulvar cancer?
Labia Major
This is where tumors are most frequently located.
How do tumors of vulvar cancer typically appear?
Tumors appear raised, ulcerated, and wartlike or leukoplakic.
What is the most common route of spread for vulvar cancer?
Direct Extension
Which structures can vulvar cancer spread to directly?
Vagina, Urethra, Anus
What are the lymphatic routes for vulvar cancer spread?
Superficial inguinal nodes, Deep inguinal nodes
How do vulvar cancers spread in relation to lymph nodes?
In an orderly pattern from inguinal lymph nodes to pelvic lymph nodes.
Is hematogenous spread common in vulvar cancer?
No, hematogenous spread is rare.
What is the primary treatment of vulvar cancer?
Surgery is the treatment of choice (TOC) for vulvar cancer.
What are the types of surgical procedures for vulvar cancer?
Local excision, vulvectomy, and bilateral inguinal lymphadenectomy.
When can preoperative radiation therapy be considered?
Preoperative radiation can be an option for patients with tumors close to critical structures.
What is definitive radiation therapy used for?
Definitive radiation can be used to treat very large tumors, where surgery may not be possible.
When is postoperative radiation therapy indicated?
Postoperative radiation can be used for patients with positive nodes in the pelvic or groin region.
In what position is the patient treated during radiation therapy?
The patient would be treated in frog-leg position.
What is neoadjuvant therapy used for?
Neoadjuvant therapy is used for advanced disease.
What is concurrent therapy in the context of vulvar cancer?
Concurrent radiation and chemotherapy can be used in treatment.
What is the recommended positioning for radiation therapy in vulvar cancer?
Supine position with legs in frog-leg position.
The frog-leg position helps decrease dose to the soft tissues of the thighs.
What is the purpose of using bolus in radiation therapy for vulvar cancer?
Bolus is used on the vulva to eliminate cold spots within the treatment area.
What technique is used to cover vulva regional lymph nodes?
AP/PA technique is used.
The patient is supine and in a frog-legged position with bolus.
What is the typical radiation dose for AP/PA technique in vulvar cancer?
50 Gy.
What is the purpose of the Electron Boost in vulvar cancer treatment?
Aimed directly at the vulva.
The patient may be positioned up on all fours with a dose of 10-20 Gy.
What is the advantage of using IMRT in vulvar cancer treatment?
IMRT spares healthy tissues, particularly skin, femoral heads and necks, and bowel, reducing long-term complications.
Why is vulvar cancer considered difficult to treat effectively?
This is a difficult cancer to treat effectively.
