Vulval cancer Flashcards
1
Q
Learning outcomes
A
- Natural history of lower genital tract malignancy
- Epidemiology and diagnosis of vulval cancer
- Principles of management of vulva cancer
- Relevance and significance of histological diagnosis
2
Q
Definition of vulval intraepithelial neoplasia
A
- Abnormal cells develop in surface layer of skin covering vulva
- Pre-cancer → not a cancer bu could turn into one
3
Q
Definition of squamous intraepithelial lesion
A
- Very rare type of VIN
- Associated with HPV infection
- Typically in younger woman aged 30-50
4
Q
Risk factors of lower tract malignancy
A
- Smoking
- Previous genital intraepithelial neoplasia
- Previous malignancy
- Immunosuppression
5
Q
Clinical features of lower genital tract malignancy
A
- Raised papular/ plaque lesion
- Erosions, nodules, warts
- Keratotic roughened appearance
- Sharp borders
- Discolouration → red, white, brown
6
Q
Management of lower urinary tract malignancy
A
- Prevent cancer
- Eliminate symptoms
- Preserve sexual function
- Preserve body image
- Topical treatments
- Emollients
- Photodynamic therapy
- CO2 laser therapy
7
Q
Definition of vulval cancer
A
- Rare gynaecological cancer
- Most commonly squamous cell carcinoma
- Can also be malignant melanoma
7
Q
Definition of vulval cancer
A
- Rare gynaecological cancer
- Most commonly squamous cell carcinoma
- Can also be malignant melanoma
8
Q
Where can vulval cancers occur
A
- Any part of the external female genitals
- Lips surround vagina (labia minora and labia majora)
- Clitoris
- Bartholin’s gland
9
Q
Risk factors for vulval cancer
A
- Advanced age
- Immunosuppression
- HPV infection
- Lichen sclerosis
10
Q
Presentation of vulval cancer
A
- Pain
- Itch
- Bleeding
- Lump/ ulcer
- Lymphadenopathy in groin
11
Q
Management of vulval cancer
A
- Establish diagnosis and staging of disease
- FNAC or core biopsy
- Sentinel lymph node biopsy
- CT/ MRI
- Surgery
- Radical local excision
- Unilateral or bilateral groin node dissection
- Radiotherapy
- Chemotherapy
12
Q
Difference between HPV and non-HPV related vulval cancer
A
- HPV related
- Younger woman
- Multifocal and multizonal
- Immunosupression associated
- Past history of VIN
- Non-HPV related
- Differentiated VIN
- Older women (aged 60 above)
- Lichen sclerosis associated
- Almost aways high grade neoplasia
