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Reproductive System Brian > Vulval Cancer > Flashcards

Vulval Cancer Flashcards

1
Q

What is the aetiology of vulval cancer?

A
  • Can be HPV or non-HPV related
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2
Q

Describe the epidemiology of vulval cancer (age group)?

A
  • 75% diagnosed over 60
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3
Q

What are risk factors for vulval cancer?

A
  • Intraepithelial neoplasia or cancer at other lower genital tract site
  • Lichen scleroses
  • Smoking
  • Immunosuppression
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4
Q

Describe the pathophysiology of vulval cancer?

A
  • Vulvar intraepithelial neoplasia (VIN)
    • Abnormal proliferation of squamous epithelium which can progress to carcinoma
    • 2 different types
    • Usual type (aka classical/warty)
      • Associated with HPV infection predominantly affecting young woman
      • Low grade (VIN 1) or high grade (VIN 2 and 3)
    • Differentiated type
      • Not HPV related, older woman
      • Always high grade
  • Progresses to carcinoma, normally squamous carcinoma
    • Malignant tumour of squamous cells
    • Grade is mild, moderate or poor
    • Uses FIGO staging
    • Greater risk of lymph node involvement than cervix squamous carcinoma, usually inguinal lymph node
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5
Q

What does VIN stand for?

A

Vulvar intraepithelial neoplasia

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6
Q

What does vulvar carcinoma start out as?

A

Vulvar intraepithelial neoplasia (VIN)

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7
Q

What is a VIN?

A
  • Abnormal proliferation of squamous epithelium which can progress to carcinoma
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8
Q

What are the 2 different types of VIN?

A
  • Usual type (aka classical/warty)
    • Associated with HPV infection predominantly affecting young woman
    • Low grade (VIN 1) or high grade (VIN 2 and 3)
  • Differentiated type
    • Not HPV related, older woman
    • Always high grade
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9
Q

Which type of VIN is associated with HPV?

A
  • Usual type (aka classical/warty)
    • Associated with HPV infection predominantly affecting young woman
    • Low grade (VIN 1) or high grade (VIN 2 and 3)
  • Differentiated type
    • Not HPV related, older woman
    • Always high grade
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10
Q

Which type of VIN has a worse prognosis?

A
  • Usual type (aka classical/warty)
    • Associated with HPV infection predominantly affecting young woman
    • Low grade (VIN 1) or high grade (VIN 2 and 3)
  • Differentiated type
    • Not HPV related, older woman
    • Always high grade
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11
Q

Which type of VIN affects older woman predominantly?

A
  • Usual type (aka classical/warty)
    • Associated with HPV infection predominantly affecting young woman
    • Low grade (VIN 1) or high grade (VIN 2 and 3)
  • Differentiated type
    • Not HPV related, older woman
    • Always high grade
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12
Q

What kind of carcinoma is vulvar cancer normally?

A
  • Progresses to carcinoma, normally squamous carcinoma
    • Malignant tumour of squamous cells
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13
Q

How is vulvar cancer graded?

A
  • Grade is mild, moderate or poor
  • Uses FIGO staging
  • Greater risk of lymph node involvement than cervix squamous carcinoma, usually inguinal lymph node
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14
Q

What staging system does vulvar cancer use?

A

FIGO staging

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15
Q

What is the presentation of vulvar cancer?

A
  • Pain
  • Itch
  • Bleeding
  • Lump/ulcer
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16
Q

Compare and contrast HPV related and non-HPV related vulvar cancer?

A
17
Q

What are the different stages of vulvar cancer?

A
18
Q

How is histopathology for vulvar cancer done?

A
  • Done by punch biopsy or excisional biopsy
  • Cancer is usually squamous carcinoma, others are rare but can be basal cell carcinoma and malignant melanoma
19
Q

Most vulvar carcinomas are squamous carcinomas, but what are other types?

A
  • Cancer is usually squamous carcinoma, others are rare but can be basal cell carcinoma and malignant melanoma
20
Q

What investigations should be done for vulval cancer?

A
  • Biopsy for histopathology
21
Q

Describe the management for vulval cancer?

A
  • Surgery
    • Individualised surgery
    • Local excision
    • Unilateral or bilateral node dissection – usually inguinal and upper femoral nodes
  • Radiotherapy/chemotherapy

Reproductive System Brian (34 decks)

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