Vulval Cancer Flashcards
How much of vulval intraepithelial neoplasia (VIN) is related to HPV?
40%
Risk factors for VIN
Smoking
Other genital intraepithelial neoplasia
Previous related malignancy
Immunosuppression
Symptoms for VIN
Raised popular plaques or lesions
Erosions, nodules, warty
Keratotic roughened appearance
Sharp border
Differentiated VIN tends to be unifocal ulcer or plaque
Discolouration (red/white/brown/pigmented)
Awful extreme itch
Investigations for VIN
Punch biopsy (dermatology) under local anaesthetic to get a histological diagnosis
Stages of VIN
VIN
VIN 2
VIN 3
SIL
Treatment of VIN
Surveillance - lower genital tract - emollients Surgery - to remove it Topical treatments Laser ablation
Risk of invasive cancer of VIN in treated vs untreated women
4% risk of invasion in treated
20-40% risk in untreated women
Is there a high recurrence or low recurrence rate of VIN with using laser ablation as a treatment?
High recurrence rate, 40-70%
Histological types of vulva
SCC (mostly) VIN Lichen sclerosis BCC Melanoma Bartholin's gland
Most common average age of vulval cancer
74 (27-97)
Vulval cancer is mostly seen in what age of women?
Older women
Symptoms of vulval cancer
Pain
itch
bleeding (in underwear, not toilet)
Lump/ulcer
Staging of vulval cancer + prognosis
1 = < 2cm = 97% survival 2 = > 2cm = 85% survival 3 = local spread + unilateral nodes = 46% survival 4 = distant/advanced local spread + pelvic nodes = 50% survival
Treatment of vulval cancer
Surgery
Radiotherapy
Chemotherapy
Is the prognosis good for vulval cancer?
Yes
