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Gynecology and Obstetrics
Vulva Cancer
Vulvar cancer is a rare type of cancer affecting the female external genitalia (vulva), where early diagnosis is critical.
ℹWhat is Vulva Cancer?
The vulva is the area that includes the clitoris, the inner and outer lips (labia majora and minora), and the vaginal opening. The most common type is Squamous Cell Carcinoma (90%). Other types include vulvar melanoma, adenocarcinoma, and Paget's disease.
The most significant risk factors are HPV infection (HPV 16, 33), lichen sclerosus, heavy smoking, and advanced age.
Common Symptoms
Persistent Itching
The most common symptom; unresponsive to standard topical creams.
Color Changes
White, darkened, or erythematous patches on the vulvar skin.
Mass or Lump
Palpable induration, verrucous growths, or nodules.
Non-healing Sores
Open sores or ulcers persisting for weeks.
Pain and Tenderness
Burning or pain during sexual intercourse or urination.
Abnormal Bleeding
Oozing-type bleeding from the vulvar area.
Diagnosis Methods
Physical Examination
Careful vulvar examination, magnified colposcopic assessment, and palpation of inguinal lymph nodes.
PAP Smear and HPV Test
Cell sampling to evaluate cancerous changes and HPV infection.
Colposcopy
Application of acetic acid or toluidine blue to highlight abnormal cells.
Biopsy
The definitive diagnostic method. Tissue from abnormal areas is examined histopathologically.
Radiological Imaging
CT, MRI, and PET-CT to evaluate disease spread.
Sentinel Lymph Node Biopsy
Removal of the lymph node closest to the tumor to search for cancer cells.
Treatments
Surgery
The most common and effective method. Wide local excision, radical local excision, partial or radical vulvectomy may be performed. The modern approach favors "Preservative Surgery".
Inguinal Lymphadenectomy
Starting with a sentinel lymph node biopsy, a full groin lymphadenectomy is performed if necessary.
Radiotherapy
Can be used as neoadjuvant, adjuvant, or primary treatment.
Chemotherapy
Usually given in low doses concurrently with radiotherapy.
Immunotherapy
Agents such as Pembrolizumab used in HPV-positive or recurrent cases.