Vulvar Neoplasms Flashcards
what neoplasms can be seen in association with vulvar dermatoses?
differentiated VIN, nonHPV squamous carcinoma of vulva
What is the most common vulvar malignancy?
squamous cell carcinoma accounts for 90%; pts commonly present with a lump and commonly have a long standing history of pruritus
What is next step after biopsy demonstrating moderately differentiated carcinoma?
definitive treatment can be recommended with radical vulvectomy and groin node dissection
What is mean age of vulvar SCC and what are risk factors?
65 mean age, smoking is known to increase risk of development, especially in setting of HPV infection
How does lichen sclerosis present?
skin appears thin, inelastic and white, with crinkled tissue paper appearance
How does Pagets disease present?
white plaque like lesions and poorly demarcated erythema, not a discrete mass
what does verrucous carcinoma look like?
cauliflower like lesions
Primary vulvar adenocarcinomas most likely arise from?
bartholin gland; for any woman over age 40 with mass in this area, biopsy should be obtained
how do you treat condyloma?
trichloroacetic acid(TCA) and imiquimod
How is VIN III treated?
wide local excision
Immunosuppressed people are at higher risk for?
HPV related conditions such as condyloma or vulvar dysplasia
What is best treatment in multifocal vulvar HSIL?
laser treatment is best choice
What is Pagets disease of the vulva?
an in situ carcinoma of the vulva. the association with breast cancer is significant but not as high as pagets disease of the nipple; fiery red mottled background with whitish hyperkeratotic areas
what are risk factors for vulvar cancer?
HPV exposure, smoking, vulvar dystrophy(lichen sclerosis) and immunocompromised states;; the two theories of vulvar pathogenesis include HPV infection and chronic inflammation from vulvar dystrophy
