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Vulval cancer

• 110 deaths / year
• elderly women 65-80
• surgical treatment, traditionally radical
• Stage 1a+ managed in cancer centres

Aetiology

• HPV
• LSA

Pathology

• squamous
• rarely melanoma

Symptoms

• pruritus
• mass
• pain
• bleeding
• ulceration
• dysuria
• discharge

Signs

• exophytic mass
• ulceration
• abnormal pigmentation
• groin mass

Investigations

• FBC / U&E
• USS groins
• specialist scanning

Staging

• Stage 1 confined to vulva
• Stage 2 vulva but > 2 cms or involvement of urethra and anus
• Stage 3 spread to inguinal nodes
• Stage 4 distant metastasis

Treatment

• radical vulvectomy + inguinal node dissection
• occasionally radiotherapy