Y5 - Vulval cancer

Question 1

what is the most common vulval cancer

Answer 1

squamous cell carcinomas (80%)

Question 2

epi

Answer 2

women

>65yrs

Question 3

RFs

Answer 3

HPV infection
vulval intraepithelial neoplasia
immunosuppression
lichen sclerosus

Question 4

what is lichen sclerosus

Answer 4

chronic inflammatory skin condition which affects genital skin (vulva) and skin around the anus

Question 5

signs and symptoms

Answer 5

lump or ulcer on labia majora
pain & tenderness
itching
bleeding
skin changes (colour/thickening)

Question 6

def

Answer 6

cancer which occurs on the outer surface area of the female genitalia

Question 7

what is the vulva

Answer 7

area of skin that surrounds the urethra and vagina including the clitoris and labia

Question 8

management

Answer 8

surgery to remove the cancer

Question 9

aetiology

Answer 9

mutations in DNA of unknown origin

Question 10

what are the most common types of vulvar cancer

Answer 10

1 vulvar squamous cell carcinoma

2 vulvar melanoma

Question 11

def of vulvar squamous cell carcinoma

Answer 11

squamous cells lining the vulva

Question 12

def of vulvar melanoma

Answer 12

pigment-producing cells

Question 13

prevention

Answer 13

limit sexual partners (increased risk of HPV)

HPV vaccine

Question 14

what is the most common site involved in vulvar cancer

Answer 14

labia majora

Question 15

staging of vulvar cancer

Answer 15

I - small tumour confined to vulva
II - spread to structures such as the urethra, vagina and anus
III - spread to lymph nodes
IV - spread extensively to lymph nodes and metastasised

Question 16

management

Answer 16

vulvectomy (wide local excision)

removal of nearby lymph nodes

Question 17

complications

Answer 17

infection
sexual dysfunction
fluid retention and leg swelling with removal of lymph nodes

Question 18

what lymph nodes may be removed

Answer 18

inguinal and femoral

Question 19

what is the sentinel lymph node

Answer 19

the main lymph node draining the tumour

Question 20

when may radiotherapy be used

Answer 20

with spread to lymph nodes and or the pelvis

Question 21

when may chemotherapy be used

Answer 21

with spread to the bones, liver, or lungs

Question 22

prognosis

Answer 22

5yr survival rate of 80%

decreases to 20% with pelvic lymph node involvement

Question 23

investigations

Answer 23

clinical exam

biopsy