Vulvar Cancer Flashcards

1
Q

Vulvar Cancer: Etiolgoy
usual v differentiated

risk factors

A

Etiology
- 4th MC GYN cancer
- cancer of the 60-80s
- non-invasive type: early 50s
- invasive/inflammation: 70s

esstential two main ways

from HPV: HSIL becomes usual type VIN
from chronic inflammation: dVIN (differntiated vulvaur intraepitheial neoplasia

so you have ususal and differentiated

Risk Factors
- smoking
- PHV status and risky sex
- history of vulvar lichen sclerosus (yeast infection/dm/incont = increase risk)
- hx. of melanoma
- HIV/immunocomp.
- low ses

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2
Q

Vulvr Atypias v Vulvar Malginancies

A

Atypias
- lichen scleroussu risk of devleoping CA
- linchen platus
- psoriasis
- HPV warts: condyloma
- HS
- lymphogranuloms venerum (from chalmydia)
- VIN (vulvar intraepithial neoplasia)

Malignancy
- Melanoma in situs
- squamouse cell carcinoma
- Pagets disease rare but think this if nipple crusts
- Adenomcarcinoma of bartholian

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3
Q

Symptoms/sigsn

A

Symptoms
- vulvar itching/burning
- changes in color or texture of skin
- texture: scaley, bumpie, rougher
- raised califlower like lesions
- dysuria
- lymphadenopathy

symptoms usually with later disease stages

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4
Q

Diagnosis of vulvar cancer

A

Diagnosis
- easiest way is to biopsy via punch of the skin in multiple areas

can perform colposcopy to eval area, but PAP not done

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5
Q

what is VIN and stages

A

VIN: vulvar intraepitheial neoplasia
- precancerous growths
- atypical dysplaisa in squamous epithelium
- vuvlar cancer is very slow growthi, will stay as VIN for years

VIN1: mild dysplasi
VIn II: moderate
VIN III: severe
VIN II: CIS: carcinoma in situs: is VIN III with full thickness invasion

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6
Q

Management of VIN

A

Diagnosed via punch biopsy

treatment regards…
- symptoms management, preserve the abiltiy to converge to cancer and presever tissue/function
- determine grade, margins, mutlifocal disease and smoking status

VIN options
- oversation: VIN I
- aldara: imiquoid
- cryotherapy
- laser never used in invasive CA
- surgery
(5-FU NOT used)

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7
Q

Vulvar Cancer: Squamous Cell

Vulvar Cancer: Melanoma

A

Squamous Cell
most common vulvar cancer
- slow growing and rarely metatstized
- only prevention is it prevent HPV

Melanoma
- 2nd type of vuvlar cancer
- only on ciltoris or labia minora

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8
Q

Treatment of Vulvar Cancer

prognosis
recurrance

A

sqaum or melanoma

surgery
- laser
- excisional: wide with/wihtout nodes
- vulvectomy

radiation and chemo preo-op (although chemo NOT HELPFUL)

prognosis
- with node invovlemd: 40%
- without node involved: 85-95%

recurrance
- usuing radiation alone is rarely used because of risks
- if surgery done and recurrance occurs: chemo/rad. alone cna be done

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