Vulval Cancer Flashcards
How common is vulval cancer?
Rare compared to other gynae cancers
What is the most common type of vulval cancer?
90% squamous cell carcinomas
What is a less common type of vulval cancer?
Malignant melanomas
What are the risk factors of vulval cancer?
- advanced age (esp 75+)
- immunosuppression
- HPV infection
- lichen sclerosus (5% get vulval cancer)
What is the premalignant condition of vulval cancer?
Vulval intraepithelial neoplasia - affecting squamous epithelium of skin
What are two of the types of VIN?
- high grade squamous intraepithelial lesion
- differentiated VIN
Who is high grade squamous intraepithelial lesion a/w/?
- HPV infection
- typically younger women aged 35-50
Who is differentiated VIN a/w/?
- lichen sclerosus
- typically occurs in older women (50-60)
How is VIN diagnosed?
With biopsy
What are some treatment options for VIN?
- watch & wait w/ close follow up
- wide local excision (surgery)
- imiquimod cream
- laser ablation
What is the presentation of vulval cancer?
Often incidental finding
- vulval lump
- ulceration
- bleeding
- pain
- itching
- lymphadenopathy in groin
Where does vulval cancer most frequently affect?
Labia majora
What appearance does vulval cancer give when it affects the labia majora?
- irregular mass
- fungating lesion
- ulceration
- bleeding
How is the diagnosis and staging done for vulval cancer?
- suspected referred for 2 week
- biopsy of lesion
- sentinel node biopsy to demonstrate LN spread
- further imaging for staging (eg CT abdomen and pelvis)
How is vulval cancer staged?
FIGO
