Vulvar cancer overview: Difference between revisions
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==Natural History, Complications and Prognosis== | ==Natural History, Complications and Prognosis== | ||
If left untreated, patients with vulvar cancer may progress to develop [[ulcer]] on vulva or wart-like patches on vulva, chronic [[pruritus]] of the vulva and lichenification. Common complications of vulvar cancer include fistula and [[metastasis]]. Prognosis is generally good, and the 5 year survival rate of patients with vulvar cancer is approximately 71.2%. | If left untreated, patients with vulvar cancer may progress to develop [[ulcer]] on vulva or wart-like patches on vulva, chronic [[pruritus]] of the vulva and lichenification. Common complications of vulvar cancer include fistula and [[metastasis]]. Prognosis is generally good, and the 5 year survival rate of patients with vulvar cancer is approximately 71.2%. | ||
==History and Symptoms== | ==Diagnosis== | ||
===History and Symptoms=== | |||
Symptoms of vulvar cancer include vulvar [[ulcer]]s, lumps, discoloration, and chronic [[pruritis]] of the vulva.<ref> Signs and symptoms of vulvar cancer. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/vulvar/signs-and-symptoms/?region=nAccessed on September 26, 2015</ref> | Symptoms of vulvar cancer include vulvar [[ulcer]]s, lumps, discoloration, and chronic [[pruritis]] of the vulva.<ref> Signs and symptoms of vulvar cancer. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/vulvar/signs-and-symptoms/?region=nAccessed on September 26, 2015</ref> | ||
==Staging== | ===Staging=== | ||
According to the FIGO [[cancer staging]] system, there are 4 stages of vulvar cancer.<ref name ="figo">{{cite web | url = http://www.igcs.org/guidelines/guideline_staging-booklet.pdf| author = International Federation of Gynecologists and Obstetricians (FIGO)| title = Staging classification and clinical practice guidelines of gynaecologic cancers | year = 2000 |accessdate = 2006-10-13}}</ref> | According to the FIGO [[cancer staging]] system, there are 4 stages of vulvar cancer.<ref name ="figo">{{cite web | url = http://www.igcs.org/guidelines/guideline_staging-booklet.pdf| author = International Federation of Gynecologists and Obstetricians (FIGO)| title = Staging classification and clinical practice guidelines of gynaecologic cancers | year = 2000 |accessdate = 2006-10-13}}</ref> | ||
== Chest X-ray== | ===Chest X-ray=== | ||
[[Chest radiography]] (CXR) may be helpful in the diagnosis of [[pulmonary]] [[metastasis]] of vulvar cancer. The characteristic findings of [[pulmonary]] [[metastasis]] are peripheral, rounded nodules of variable size scattered throughout both [[lungs]]. | [[Chest radiography]] (CXR) may be helpful in the diagnosis of [[pulmonary]] [[metastasis]] of vulvar cancer. The characteristic findings of [[pulmonary]] [[metastasis]] are peripheral, rounded nodules of variable size scattered throughout both [[lungs]]. | ||
==CT scan== | ===CT scan=== | ||
A CT scan for vulvar cancer may be helpful in determination of tumor size and shape and to detect metastases of vulvar cancer.<ref>Vulvar Cancer. American Cancer Society. http://www.cancer.org/acs/groups/cid/documents/webcontent/003147-pdf.pdf on October 1, 2015</ref> | A CT scan for vulvar cancer may be helpful in determination of tumor size and shape and to detect metastases of vulvar cancer.<ref>Vulvar Cancer. American Cancer Society. http://www.cancer.org/acs/groups/cid/documents/webcontent/003147-pdf.pdf on October 1, 2015</ref> | ||
==MRI== | ===MRI=== | ||
MRI useful in accurately assessing the size of vulval lesion and assessing groin lymph node metastasis.<ref>Primary vulval cancer. Radiopaedia.org. http://radiopaedia.org/articles/primary-vulval-cancer Accessed on october 1, 2015</ref> | MRI useful in accurately assessing the size of vulval lesion and assessing groin lymph node metastasis.<ref>Primary vulval cancer. Radiopaedia.org. http://radiopaedia.org/articles/primary-vulval-cancer Accessed on october 1, 2015</ref> | ||
Revision as of 10:38, 2 October 2015
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]
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Overview
Vulvar cancer accounts for about 5% of cancers of the female genital system in the United States. The vulva is the area immediately external to the vagina, including the mons pubis, labia, clitoris, Bartholin glands, and perineum. The labia majora are the most common site of vulvar carcinoma involvement and account for about 50% of cases. The labia minora account for 15% to 20% of vulvar carcinoma cases. The clitoris and Bartholin glands are less frequently involved. Lesions are multifocal in about 5% of cases. About 90% of vulvar carcinomas are squamous cell cancers. The vulvar intraepithelial neoplasias (VIN), may be precursors to invasive squamous cell cancers.[1]
Classification
Vulvar cancer may be classified according to histology into 3 groups: vulvar carcinoma, vulvar sarcoma and vulvar malignant melanoma.[2]
Pathophysiology
Development of vulvar cancer is the result of multiple genetic mutations.
Causes
Vulvar cancer may be caused by either HPV infection, or vulvar dermatoses.
Differential Diagnosis
Vulvar cancer must be differentiated from other neoplastic vulvar lesions, non neoplastic vulvar lesions and infectious disease lesions of vulva.
Epidemiology and Demographics
In 2012, the incidence of vulvar cancer was estimated to be 2.4 per 100,000 females in the United States. The incidence of vulvar cancer increases with age, the median age at diagnosis is 68 years and it is more prevalent in the white race.[3]
Risk factors
Common risk factors in the development of vulvar cancer are human papilloma virus, human immunodeficiency virus, vulvar intraepithelial neoplasia, and lichen sclerosus.[4]
Screening
Screening for vulvar cancer is not recommended.[5]
Natural History, Complications and Prognosis
If left untreated, patients with vulvar cancer may progress to develop ulcer on vulva or wart-like patches on vulva, chronic pruritus of the vulva and lichenification. Common complications of vulvar cancer include fistula and metastasis. Prognosis is generally good, and the 5 year survival rate of patients with vulvar cancer is approximately 71.2%.
Diagnosis
History and Symptoms
Symptoms of vulvar cancer include vulvar ulcers, lumps, discoloration, and chronic pruritis of the vulva.[6]
Staging
According to the FIGO cancer staging system, there are 4 stages of vulvar cancer.[7]
Chest X-ray
Chest radiography (CXR) may be helpful in the diagnosis of pulmonary metastasis of vulvar cancer. The characteristic findings of pulmonary metastasis are peripheral, rounded nodules of variable size scattered throughout both lungs.
CT scan
A CT scan for vulvar cancer may be helpful in determination of tumor size and shape and to detect metastases of vulvar cancer.[8]
MRI
MRI useful in accurately assessing the size of vulval lesion and assessing groin lymph node metastasis.[9]
References
- ↑ General Information About Vulvar Cancer. National Cancer Institute. http://www.cancer.gov/types/vulvar/hp/vulvar-treatment-pdq Accessed on october 1, 2015
- ↑ Hoffman, Barbara (2012). Williams gynecology. New York: McGraw-Hill Medical. ISBN 9780071716727.
- ↑ SEER Stat Fact Sheets: Vulvar Cancer. Surveillance, Epidemiology, and End Results Program. http://seer.cancer.gov/statfacts/html/vulva.html Accessed on September 21, 2015
- ↑ Risk factors for vulvar cancer. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/vulvar/risks/?region=ns Accessed on September 27, 2015
- ↑ What Should I Know About Screening? Gynecologic Cancers. http://www.cdc.gov/cancer/vagvulv/basic_info/screening.htm Accessed on September 30, 2015
- ↑ Signs and symptoms of vulvar cancer. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/vulvar/signs-and-symptoms/?region=nAccessed on September 26, 2015
- ↑ International Federation of Gynecologists and Obstetricians (FIGO) (2000). "Staging classification and clinical practice guidelines of gynaecologic cancers" (PDF). Retrieved 2006-10-13.
- ↑ Vulvar Cancer. American Cancer Society. http://www.cancer.org/acs/groups/cid/documents/webcontent/003147-pdf.pdf on October 1, 2015
- ↑ Primary vulval cancer. Radiopaedia.org. http://radiopaedia.org/articles/primary-vulval-cancer Accessed on october 1, 2015