vulval cancer

see also:

• human papilloma virus (HPV)
• cervical cancer
• oncology

• like cervical cancer, vulval carcinoma is associated with human papilloma virus (HPV) infection
• striking increase in vulval intraepithelial neoplasia (VIN) since 1980 with the median age of presentation falling to the mid-30's
  • at least 2/3rds of these women smoke cigarettes
  • nearly 50% have PH of SIL/CIN
  • many of the younger women have HPV DNA on biopsy
• other risk factors:
  • lichen sclerosis - thin, white, wrinkled patches, mainly genital / anal areas esp. in post-menopausal women, often itchy esp. at night, and is a risk factor for vulval cancer - this risk can be reduced by long term topical steroids such as clobetasol

• vulvar pruritus
• vulval lump
• warty vulvar lesion which may be unifocal or multifocal, flat, papular or in extensive plaques, pigmented, white or red
• transit times from VIN III to invasion is less than 8yrs in nearly all studies, thus any gross lesion should be biopsied or referred to a vulvar specialist