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Reproductive > Vulval cancer > Flashcards

Vulval cancer Flashcards

1
Q

What group of patients most commonly presents with vulva cancer?

A

> 60s

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2
Q

What are the signs/symptoms of vulval cancer?

A

Pain
Itch
Bleeding
Lump/ulcer

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3
Q

What are risk factors for vulval cancer?

A 
Intraepithelial neoplasia or cancer at other lower genital tract site
Lichen sclerous
Smoking
Immunosuppression
HPV infection
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4
Q

What is lichen sclerosis?

A

Chronic dermatitis which causes itch and irritation - lesions present as white papules and plaques

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5
Q

What is the staging for vulval cancer?

A

Surgical-pathological

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6
Q

What is stage 1A of vulva cancer?

A

‘Micro-invasion’ <1mm

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7
Q

What is used to stage vulva cancer?

A

Size of lesion

Lymph node involvement: inguinal and upper femoral, pelvic

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8
Q

Which node involvement suggests advanced vulva cancer?

A

Pelvic nodes

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9
Q

What is VIN?

A

Vulvar intraepithelial neoplasia

Precancerous lesion caused by dysplasia of squamous cells

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10
Q

What are two types of VIN?

A

HPV related and non-HPV related

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11
Q

Is differentiated VIN associated with HPV?

A

No

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12
Q

Who is differentiated VIN usually found in?

A

Older women

Associated with lichen sclerosus

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13
Q

Which type of VIN has a higher risk of presenting as cancer ?

A

Differentiated, non-HPV related, VIN

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14
Q

What are the symptoms of VIN?

A

Itching
Pain
Changes to the vulval skin
Dyspareunia

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15
Q

What is HPV VIN associated with?

A 
Young women
Multifocal 
Multizonal
Immunosuppression
PHx intraepithelial neoplasia
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16
Q

What are the stages of vulva cancer?

A

Stage 1-4

17
Q

What size is a stage 1 vulva cancer?

A

<2cm

18
Q

What size is a stage 2 vulva cancer?

A

> 2cm

19
Q

What is a stage 3 vulva cancer

A

Local spread

Unilateral nodes

20
Q

What is a stage 4 vulva cancer?

A

Distant or advanced local spread

Pelvic nodes

21
Q

What is the treatment for vulva cancer?

A

Surgery

Radiotherapy/chemotherapy

22
Q

What are the surgery options for vulva cancer?

A

Individualised surgery - radical vulvectomy
Local excision
Unilateral or bilateral node dissection

23
Q

Why is groin node dissection associated with significant morbidity?

A

Wound infection
Lymphocysts
Nerve damage

24
Q

What nodes are dissected in a groin node dissection?

A

Inguinal and upper femoral

25
Q

Overall, what groups does vulva cancer usually affect?

A

Older women - pain/ulcer

Young women - VIN

26
Q

What type of cancer are the majority of vulva cancers?

A

Squamous cell carcinomas

27
Q

What are the investigations for vulval cancer?

A

Pelvic exam and colposcopy

Biopsy

Reproductive (20 decks)

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