9 - Vulval Cancer Flashcards

1
Q

what age is most common for diagnosis of vulval cancer?

A

age 74

75% of diagnoses > 60 years

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2
Q

4 main symptoms of VC?

A

pain

itch

bleeding

lump/ulcer

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3
Q

4 RFs of VC?

A

Intraepithelial neoplasia/ cancer at other lower genital tract site

Lichen sclerosus

Smoking

Immunosuppression

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4
Q

VIN?

A

Vulva intra-epithelial Neoplasia

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5
Q

when is VIN likely?

A

when the cancer is HPV related

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6
Q

HPV related VC - who is usually affected and what do they have a history of?

A

younger women with history of VIN and immunosuppression

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7
Q

when is differentiated VIN likely?

A

when VC is non-HPV related

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8
Q

non-HPV related VC - who is usually affected and what do they have a history of?

A

older women with history of lichen sclerosus and presents as cancer at first diagnosis

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9
Q

describe stage 1 VC in terms of size, nodes involved and survival rates?

A

<2cm
no nodes
97% survival

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10
Q

describe stage 2 VC in terms of size, nodes involved and survival rates?

A

> 2cm
no nodes
85% survival

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11
Q

describe stage 3 VC in terms of size, nodes involved and survival rates?

A

local spread
unilateral nodes
46% survival

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12
Q

describe stage 4 VC in terms of size, nodes involved and survival rates?

A

distant/ advanced local spread
pelvic nodes
50% survival

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13
Q

how is histopathology achieved?

A

punch/ excisional biopsy

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14
Q

possible inflammatory diagnosis of histopathology?

A

lichen sclerosus

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15
Q

possible dysplasia diagnosis of histopathology?

A

VIN

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16
Q

possible malignant diagnosis of histopathology?

A

squamous cell carcinoma

17
Q

definition of VIN?

A

Abnormal proliferation of squamous epithelium; can progress to carcinoma

18
Q

usual type of VIN?

A

Associated with HPV infection

Low grade (VIN 1) or high grade (VIN 2 and 3)

19
Q

differentiated type of VIN?

A

In older women

not HPV related

always high grade

20
Q

type of cell present in classical VIN histology slide?

A

Koilocyte

21
Q

staging used for VC?

A

FIGO staging

22
Q

what is important to measure for squamous cell carcinoma?

A

depth of the invasion

23
Q

what can be seen in squamous cell carcinoma histology slides?

A

keratinisation

24
Q

3 types of surgery to treat vulva cancer?

A

individualised surgery

local excision

unilateral/ bilateral node dissection

25
Q

other treatments for VC?

A

radiotherapy

chemotherapy

26
Q

what does groin node dissection involve?

A

inguinal and upper femoral nodes

27
Q

3 aspects of significant morbidity associated with groin node dissection?

A

Wound infection

Lymphocysts

Nerve damage