Updated: 2/13/2018

Vulvular Cancer

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Snap Shot
  • A 42-year-old G4P4 woman complains of vulvar itching and a raised lesion.
Introduction
  • Several types
    • squamous cell carcinoma
      • 90% of vulvular cancers
      • risk factors
        • HPV 16 positivity
        • smoking
        • immunosuppression
    • vulvar intraepithelial neoplasia (VIN)
      • VIN I and II = mild to moderate dysplasia.
        • ↑ risk of carcinoma
      • VIN III = carcinoma in situ
      • strong HPV 16 association
      • may lead to squamous cell carcinoma
    • extramammary Paget's disease
      • PAS positive due to mucin production
    • malignant melanoma
      • similar histologically to Paget's but PAS negative
Presentation
  • Symptoms
    • pruritus
    • irritation and itching
    • raised/crusted lesion
Evaluation
  • Biopsy
Treatment
  • Excision
 

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