Vulval cancer

Question 1

What is the aetiologyq

Answer 1

VIN (HPV)
Lichen sclerosis (5% go on to malignancy)

Question 2

What cells are most made up of?

Answer 2

squamous

Question 3

What are sx

Answer 3

→	Vulval itching
→	Vulval soreness 
→	Persistent ‘lump’
→	Indurated (hardened) ulcer
→	Bleeding
→	Pain on passing urine
→	Past Hx of VIN or lichen Sclerosis

Question 4

What is the staging

Answer 4

¥ I <2cm (79% 5 yr survival)
¥ II >2cm (59% 5 yr survival)
¥ III Adjacent organs / Unilateral Nodes (43% 5 yr survival)
¥ IV Bilateral nodes / Distant mets (13% 5 yr survival)

Question 5

What is the treatment

Answer 5

<2cm wide and <1mm deep - no LN excision
>1mm deep - triple incision surgery = wide local incision + ipsilateral groin node biopsy
surgery (radical vulvectomy)