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Reproductive System > Vulval Cancer > Flashcards

Vulval Cancer Flashcards

1
Q

What is the peak age for vulvar cancer?

A
  • 27-97

* 75% diagnosed over age 60

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2
Q

How does vulvar cancer present?

A
  • Pain
  • Itch
  • Bleeding
  • Lump/ulcer
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3
Q

What are the risk factors for vulvar cancer?

A
  • Intraepithelial neoplasia or cancer at other lower genital tract site
  • Lichen sclerosus
  • Smoking
  • Immunosuppression
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4
Q

How is vulvar cancer staged?

A
  • Staging surgical-pathological
  • Stage 1a ‘micro-invasion’ < 1mm
  • Size of lesion
  • Lymph node involvement - inguinal and upper femoral, pelvic
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5
Q

Describe HPV-related vulvar cancer?

A
  • Usual type VIN - vulvar intraepithelial neoplasia
  • Younger women
  • Multifocal
  • Multizonal - cervix, vagina, perianal skin, anal mucosa
  • Immunosuppression
  • Past history of intra-epithelial neoplasia
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6
Q

Describe non-HPV-related vulvar cancer?

A
  • Differentiated VIN
  • Older women
  • Lichen sclerous
  • Often present as cancer at first diagnosis
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7
Q

What is stage 1 of vulvar cancer?

A
  • <2cm

* Survival - 97%

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8
Q

What is stage 2 of vulvar cancer?

A
  • > 2cm

* Survival - 85%

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9
Q

What is stage 3 of vulvar cancer?

A
  • Local spread
  • Unilateral lymph nodes
  • Survival - 46%
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10
Q

What is stage 4 of vulvar cancer?

A
  • Distant or advanced local spread
  • Pelvic lymph nodes
  • Survival - 50%
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11
Q

How is a biopsy taken in vulvar cancer?

A

Punch biopsy or excisional biopsy

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12
Q

What is the histopathology of vulvar cancer?

A
  • Inflammatory, including lichen sclerosus
  • Dysplasia - VIN
  • Malignant - squamous cell carcinoma
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13
Q

What is vulvar intraepithelial neoplasia?

A

Abnormal proliferation of squamous epithelium; can progress to carcinoma

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14
Q

What is usual type VIN?

A
  • Associated with HPV infection

* Low grade (VIN 1) or high grade (VIN 2 and 3)

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15
Q

What is differentiated type VIN?

A
  • In older women, not HPV related

* Always high grade

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16
Q

What staging is used in vulvar cancer?

A

FIGO

17
Q

What is squamous cell carcinoma?

A
  • Malignant tumour of squamous cells

* Ability to invade adjacent tissues and spread to distant sites (metastasis)

18
Q

How is vulvar cancer treated?

A

•Surgery

  • individualised surgery
  • local excision
  • unilateral or bilateral node dissection

•Radiotherapy/Chemotherapy

19
Q

What is groin node dissection used for?

A
  • Inguinal and upper femoral nodes
  • Separate node incisions
  • Staging and remove nodal disease
20
Q

What are the risks associated with groin node dissection?

A
  • Associated with significant morbidity
  • Wound infection
  • Lymphocysts
  • Nerve damage
21
Q

Summary

A
  • Rare cancer
  • Older women with pain/ulcer/lump
  • Young women with VIN
  • Treatment is surgery
  • Prognosis is good

Reproductive System (31 decks)

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