Vulvar and Vaginal Cancer Flashcards
Risk factors of vulva cancer x5
Smoking
HPV infection
Increasing age
Immunodeficiency
Lichen sclerosus
Types of vulvar cancers x5
Vulvar carcinomas- SCC, adeno, basal cell
Vulvar malignant Melanoma
Vulvar Sarcoma
Clinical presentation of vulvar SCC x5
Unifocal lesion
Pruritus
Burning sensation
Vulvar bleeding
Lymphadenopathy
Risk factors of vulvar cancers x6
Old age >50HSV infection
Chronic immunosuppression
HPV infection
Lichen sclerosus
Pelvic radiation
Smoking
Indications for biopsy of vulvar lesion x3
- Lesion/genital wart in postmenopausal or immunodeficient woman
- Genital wart not going away with topical treatment
- Evolving lesion
Pathophysiology of vulvar cancer x5
HPV contains oncoproteins E6 and E7 which inactivate p53 and Rb tumor suppressor genes respectively
Results in uncontrolled cellular proliferation in vulvar tissue
3 types of vulvar squamous intraepithelial lesions (SIL)
Low grade SIL
High grade SIL
Differentiated VIN
Whats the pattern of spread of vulvar cancer x5
Growth of primary tumor
Extension to surrounding organs
Embolization into regional lymph nodes
Distant spread- beyond deep inguinal nodes
Dissemination via hematologic and lymphatic vessels
Describe stage II of vulvar cancer
II- confined to vulva/perineum and greater than 2cm
Describe stage III of vulvar cancer
Spread to lower urethra/vagina/anus
+/- local LN on one side
Describe stage IV A and B of vulvar cancer
A- Upper urethra/bladder/rectum
- local LNs on both sides
B- pelvic LNs and distant organs
Treatment of vulvar cancer x4
Surgical:
1. Radical vulvectomy + inguinofemoral lymphadenectomy
2. Wide local excision
Chemotherapy
Radiation
Epithelium of vagina
Non keratinized stratified squamous epithelium
4 subtypes of vag cancer
Squamous cell carcinoma
Melanoma
Sarcoma
Adenocarcinoma
Risk factors of vag cancer x7
Increasing age
Immunosuppression
Smoking
Pelvic radiation
HPV infection
Multiple sexual partners
Hx of cervical/vulvar cancer
