Malignant Vulvar Lesions

The vulvar cancer is 3 times more frequent in underdeveloped countries and it accounts for approximately 5% of all female genital cancers . In general this type of cancer occurs to women aged 60- 70. It can also appear to much younger females that have early microcarcinomas associated with diffuse intraepithelial neoplasia of the vulva.

For setting the diagnosis a dermal punch biopsy can be used. The excision can be also therapeutic if the lesion is small . Because the vulva is covered on skin, all the problems that occur elsewhere on the skin also can occur on the vulva . There are many growth characteristics of the vulvar cancer . It can occur in an area of epithelial neoplasia that develops into a small nodule that can ulcerate .

The cancer can appear anywhere on the vulva, but is it know that about 70% appear first on the labia . Very rarely, because the vulva is rich in lymphatics, metastasis to the inguinal lymph node can occur.

The cause of this type of cancer is unknown. For younger women a possible cause can be VIN. For older ones the cancer may appear because poor perinea hygiene, obesity, vulvar dystrophies, squamous cell carcinoma of the cervix or vagina associated with squamous carcinoma of the vulva .

The vulvular malignancies may be classified into : carcinoma of Bartholin’s gland, malignant melanoma, sarcoma, squamous cell cancer.

From them, the most common vulvar malignancy, that involves the anterior half of the vulva is the squamous cell cancer. In this case the tumor appearance varies from a small ulcer crater o a large exophytic cauliflower- like lesion. This cancer can spread to adjacent structures like vagina, bladder. In comparison to squamous carcinoma, melanoma has a high risk of metastasis..

The treatment of this type of condition is generally handled by an oncologist. Surgery is often recommended and it is accomplished by use of a radical vulvectom. The complications for such a surgery include sexual dysfunction, infection, thrombosis and edema. When vulvar cancer has spread to adjacent organs such as urethra, vagina, surgery is more complicated and more extensive . It will also be more disfiguring.

In advanced vulvular cancer cases, the treatment will include radiation therapy and chemotherapy.

The prognosis of such a cancer is about 5 years of life but this depends of course of the stage and type of the lesion, on the age and the medical health of the patient .

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