Valvular

Question 1

What is the most common type of vulvar cancer?

Answer 1

Squamous cell carcinoma of the vulva.

Question 2

Which age group is most affected by vulvar cancer?

Answer 2

Postmenopausal women, typically age >60.

Question 3

What is the second most common type of vulvar malignancy?

Answer 3

Melanoma.

Question 4

What are the two major pathophysiologic pathways of vulvar cancer?

Answer 4

HPV-associated and non-HPV-associated pathways.

Question 5

What virus is commonly associated with vulvar squamous cell carcinoma in younger women?

Answer 5

High-risk HPV, especially HPV type 16.

Question 6

What lifestyle factor increases vulvar cancer risk, particularly in HPV-positive cases?

Answer 6

Smoking.

Question 7

What chronic skin condition predisposes older women to non-HPV vulvar cancer?

Answer 7

Lichen sclerosus.

Question 8

What immunologic state increases risk for vulvar cancer?

Answer 8

Immunosuppression, such as HIV or immunosuppressive therapy.

Question 9

What is the most common presenting symptom of vulvar cancer?

Answer 9

Persistent vulvar pruritus.

Question 10

What is a common physical finding of vulvar cancer?

Answer 10

Ulcerated, raised, or pigmented lesion on the vulva.

Question 11

What symptom may suggest lymph node involvement?

Answer 11

Palpable groin mass or inguinal lymphadenopathy.

Question 12

What advanced symptom may indicate local invasion?

Answer 12

Pain, bleeding, or discharge.

Question 13

What is the first step in evaluating a suspicious vulvar lesion?

Answer 13

Punch biopsy of the lesion.

Question 14

What are suspicious features of a vulvar lesion that warrant biopsy?

Answer 14

Lesion that is itchy, pigmented, ulcerated, or persistent.

Question 15

What imaging is used to evaluate for metastasis or nodal spread?

Answer 15

MRI or CT scan of pelvis and groin.

Question 16

What histologic feature is typical of non-HPV related vulvar cancer?

Answer 16

Well-differentiated squamous cell carcinoma.

Question 17

What is VIN and why is it important?

Answer 17

Precancerous lesion that can progress to vulvar cancer if untreated.

Question 18

What virus is VIN associated with?

Answer 18

HPV, particularly type 16.

Question 19

How is VIN diagnosed?

Answer 19

Vulvar biopsy of abnormal areas.

Question 20

What are treatment options for VIN?

Answer 20

Wide local excision, laser ablation, or topical imiquimod.

Question 21

What is the treatment for early-stage vulvar cancer?

Answer 21

Wide local excision or radical vulvectomy with sentinel lymph node biopsy.

Question 22

What is the role of lymph node assessment in vulvar cancer?

Answer 22

Important for staging and prognosis.

Question 23

What is the treatment for locally advanced vulvar cancer?

Answer 23

Radical vulvectomy + bilateral inguinofemoral lymphadenectomy ± radiation/chemotherapy.

Question 24

What therapy is added for patients with positive margins or nodal spread?

Answer 24

Adjuvant radiation or chemoradiation.

Question 25

How is vulvar melanoma managed?

Answer 25

Wide local excision with sentinel lymph node biopsy.

Question 26

What is Paget disease of the vulva associated with?

Answer 26

Often linked to underlying malignancy (GI, breast, GU).

Question 27

How is vulvar Paget disease diagnosed?

Answer 27

Biopsy of eczematous or red lesion.

Question 28

What is the treatment for Paget disease of the vulva?

Answer 28

Wide local excision, monitor for recurrence and underlying malignancy.

Question 29

What staging system is used for vulvar cancer?

Answer 29

FIGO staging.

Question 30

What is the single most important prognostic factor in vulvar cancer?

Answer 30

Lymph node involvement.

Question 31

What size and depth define Stage I vulvar cancer?

Answer 31

Confined to vulva, ≤2 cm in size and <1 mm stromal invasion.

Question 32

When is sentinel lymph node biopsy preferred over full lymphadenectomy?

Answer 32

In early-stage, unifocal lesions <4 cm, no clinical nodal disease.

Question 33

How often should patients be followed after vulvar cancer treatment?

Answer 33

Every 3–6 months for the first 2 years, then annually.

Question 34

What signs should prompt suspicion of recurrence?

Answer 34

New lesions, pruritus, pain, or lymphadenopathy.

Question 35

What imaging is used for surveillance of recurrence?

Answer 35

MRI or PET-CT, based on symptoms or findings.

Question 36

What vaccine helps prevent HPV-related vulvar cancer?

Answer 36

HPV vaccine (covers HPV 16, 18, etc.).

Question 37

What lifestyle modification reduces vulvar cancer risk?

Answer 37

Smoking cessation.

Question 38

What should be done with chronic lichen sclerosus in older women?

Answer 38

Regular surveillance and biopsy of any changing areas.

Question 39

Why is early biopsy critical in suspicious vulvar lesions?

Answer 39

Early diagnosis leads to less invasive treatment and better outcomes.

Question 40

Can vulvar cancer be prevented?

Answer 40

Risk can be reduced, especially for HPV-associated types, but not fully prevented—requires vigilance and early detection.