Vulval cancer Flashcards
What is the most common form of vulval cancer
Squamous cell carcinoma
What is a rarer form of vulval cancer
Malignant melanoma
Risk factors for vulval cancer
- Advanced age (particularly over 75 years)
- Immunosuppression
- Human papillomavirus (HPV) infection
- Lichen sclerosus (5%)
What is the precursor lesion for vulval SCC
Vulval intraepithelial neoplasia (VIN)
What is a high grade squamous intraepithelial lesion
A type of VIN associated with HPV infection, affecting women aged 35-50
What is differentiated VIN?
An alternative type of VIN associated with lichen sclerosus, affecting women aged 50-60
Management of VIN
- Watch and waitwith close followup
- Wide local excision(surgery) to remove the lesion
- Imiquimodcream
- Laser ablation
5 year survival rate for node enegative vulval cancer
90%
5 year survival rare for node positive vulval cancer
<60%
What is Vulvar Paget’s disease?
A crusting, painful rash of mucin containing tumour cells arising from the glandular cells of folliculosebaceous or eccrine glands
Symptoms of vulval cancer
- Vulval lump
- Ulceration
- Bleeding
- Pain
- Itching
- Lymphadenopathy in the groin
What is the most commonly affected part of the vulva by vulval cancer
Labia majora
Appearance of vulval cancer
- Irregular mass
- Fungating lesion
- Ulceration
- Bleeding
Diagnosing vulval cancer
- Biopsyof the lesion
- Sentinel node biopsyto demonstrate lymph node spread
- Further imaging for staging (e.g. CT abdomen and pelvis)
Management of vulval cancer
- Wide local excision to remove the cancer
- Groin lymph node dissection
- Chemotherapy
- Radiotherapy
