Vulval Cancer Flashcards
What is the peak age for vulva cancer?
74 years
75% diagnosed over age 60
What is the presentation of vulva cancer?
Pain, itch, bleeding and lump/ ulcer
What are the risk factors of vulva cancer?
Intraepithelial neoplasia or cancer at other lower genital tract site
Lichen sclerosus
Smoking
Immunosuppression
What is the HPV related vulva cancer?
Squamous cell
Usual type VIN, younger women, multifocal, multizonal, immunosuppression and past history of intraepithelial neoplasia
What is non-HPV related vulva cancer?
Differentiated VIN, older women, lichen sclerosus and often presents as cancer at first diagnosis
What is stage 1 and 2 of vulva cancer?
1 is under 2cm - 97% survival
2 is over 2 cm
Both no node involvement
What is stage 3 and 4 of vulva cancer?
3 is local spread and unilateral nodes
4 is distant or advanced local spread and pelvic node involvement
Describe vulvar intraepithelial neoplasia
Abnormal proliferation of squamous epithelium and can progress to carcinoma
Usual type - classical/ warty
Differentiated type
What is usual type vulvar intraepithelial neoplasia?
Associated with HPV infection
Low grade (VIN 1) or high grade (VIN 2 and 3)
What is differentiated type vulvar intraepithelial neoplasia?
In older women and not HPV related
Always high grade
Describe squamous cell carcinoma
Malignant tumour
Ability to invade adjacent tissues and spread to distant sites
Grade on how bad and stage on spread
FIGO staging
What treatment can be done for vulva cancer?
Individualised surgery
Local excision
Unilateral or bilateral node dissection
Radiotherapy/ chemotherapy
Describe groin node dissection
Inguinal and upper femoral nodes
Separate node incisions
Separate and remove nodal disease
Associated with significant morbidity - wound infection, lymphatics and nerve damage
What are the main features of vulva cancer?
Rare, older women with pain/ ulcer/ lump, young women with VIN, treatment is surgery and prognosis is good
