Vulval Cancer Flashcards
1
Q
What type of cancer is vulval cancer?
A
- 90% are squamous cell carcinomas
- they may also be malignant melanomas
- vulval cancer is RARE
2
Q
What are the risk factors for vulval cancer?
A
- advanced age (>75)
- immunosuppression
- HPV infection
- lichen sclerosus
lichen sclerosus - itchy white patches on the genitals
3
Q
What is vulval intraepithelial neoplasia (VIN)?
A
- a premalignant condition
- it affects the squamous epithelium
- it precedes vulval cancer
4
Q
What is a high grade squamous intraepithelial lesion?
A
- a type of VIN associated with HPV infection
- typically occurs in younger women aged 35-50 years
5
Q
What is differentiated VIN?
A
- a type of VIN associated with lichen sclerosus
- typically occurs in older women aged 50-60 years
6
Q
How is VIN treated?
A
- VIN is confirmed with a biopsy
- watch and wait with close follow-up
- wide local excision to remove lesion
- laser ablation
- imiquimod cream
7
Q
How does vulval cancer typically present?
A
- a vulval lump
- itching
- ulceration
- pain / bleeding
- lymphadenopathy in the groin
it is often asymptomatic and an incidental finding (e.g. during catheterisation of an elderly patient)
8
Q
Which region is most commonly affected by vulval cancer?
A
labia majora
- this gives an appearance of:
- irregular mass
- fungating lesion
- ulceration
- bleeding
9
Q
What is involved in diagnosing and staging vulval cancer?
A
biopsy:
- biopsy of the lesion is taken to confirm diagnosis
sentinel node biopsy:
- to confirm lymph node spread
staging CT:
- of the pelvis + abdomen
