Vulvar, Vaginal and Ovarian Tumors Flashcards
Epidemiology of vulvar cancer
- 4-8% of all gynecologicial tumors
- older women
Etiology of vuvlvar cancer
- poor hygiene
- chronic inflammation
- HPV
Histology of vulvar cancer
- Planocellular carcinoma
- keratonizing
- nonkeratonizing
- Verrucous carcinoma
Symptoms of vulvar cancer
- invasion to vagina, anus, urinary meatus, pelvic bones
- discharge, itching, ulcerated
Diagnosis of vulvar cancer
- inguinal US and pelvic CT/MRI
- palpation of tumors and inguinal lymph node regions
- bimanual rectovaginal examination
- incisional biopsy
Radiation therapy for vulvar cancer
- postop. RT
- definitive: EBRT if unresectable
Surgical therapy for vulvar cancer
- surgery is first option
- local wide resection
- radical vulvectomy w/ or w/o adjuvant RT
Pharmacological therapy for vulvar cancer
cisplatin-5-FU
Epidemiology of vaginal cancer
- 1-2% of all gynecological tumors
- difficult to diagnose
Etiology of vaginal cancer
HPV
Histology of vaginal cancer
- occurs mostly on posterior wall of upper third vagina
- vaginal intraepithelial neoplasia (VAIN): non invasive
- FIGO
Symptoms of vaginal cancer
- vaginal discharge
- vaginal bleeding
Diagnosis of vaginal cancer
- physical
- inguinal US
- pelvic CT/MRI
- incisional biopsy
Radiotherapy for vaginal cancer
- early tumor: definite RT
- advanced tumor: EBRT + brachytherapy (surgery is not an option)
- postop. RT: HDR brachytherapy for stages 1-3
Surgical therapy for vaginal cancer
- first option for small tumors
- if invasive, similar to therapy for vulva
Pharmacological therapy for vaginal cancer
cisplatin-5-FU
Epidemiology of ovarian cancer
- highest mortality due to no symptoms or screening
- epithelial ovarian cancer is the second most common of ovarian cancers
- avg. age: 65 years
Etiology of ovarian cancer
- unknown
- possible connection w/ ovulation
- originates in Muller’s duct from BRCA1/2 mutation (11% of cases)
Histology of ovarian cancer
- epithelial (adult)
- high-grade serous carcinoma: p53
- low-grade serous carcinoma: KRAS
- endometrioid
- clear cell
- germ (younger ages)
- sex cord
Symptoms of ovarian cancer
- no early symptoms
- bloating
- discomfort
Diagnosis of ovarian cancer
- CA-125 blood test
- palpate douglas pouch
- imaging
- core-needle biopsy
Radiotherapy for ovarian cancer
whole abdomen RT: RT for whole abd. cavity due to possible lymphatic/peritoneal invasion
Surgical therapy for ovarian cancer
- primary treatment: surgery + chemotherapy
- laporatomy w/ resection of uterus, fallopian tube, and omentum
- pelvic/paraortic lymphadenectomy
- prophylactic surgery for BRCA genes
Pharmacological therapy for ovarian cancer
adjuvant chemo: carboplatin-pacilataxel
