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Vulvar Malignancy

Sareena Singh, MD, FACOG and Lauren Ann Hutka, D.O. Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Premalignant lesions of the vulva are collectively known as vulvar intraepithelial neoplasia (VIN).

  • Exposure to human papillomavirus (HPV) has been linked to >70% of VIN.

  • Invasive s...

DIAGNOSIS

HISTORY

Complaints of pruritus or raised lesion in the vaginal area, vaginal bleeding, discharge 

PHYSICAL EXAM

  • In situ disease: a small raised area associated with pruritus, single vulvar plaq...

TREATMENT

GENERAL MEASURES

  • Wide excision can be performed for carcinoma in situ, and any suspicious lesion should be excised for definitive diagnosis.

  • Cystoscopy and sigmoidoscopy should be performed if...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Early stage, treated with surgery alone: clinical exam of the groin nodes and vulvar area every 6 months for 2 years and then annually

  • Following ...

ADDITIONAL READING

Hinten  F, Molijn  A, Eckhardt  L, et al. Vulvar cancer: two pathways with different localization and prognosis. Gynecol Oncol.  2018;149(2):310–317. [View...

CODES

ICD10

  • C51.9 Malignant neoplasm of vulva, unspecified

  • D07.1 Carcinoma in situ of vulva

  • C51.0 Malignant neoplasm of labium majus

  • C51.1 Malignant neoplasm of labium minus

  • C51.8 Malignant neoplasm of ove...

CLINICAL PEARLS

  • 55% of vulvar cancers are attributable to oncogenic HPV. VAIN 2/3 and AIN are attributable to HPV. Therefore, HPV vaccination has the potential to decrease vulvar cancer by 1/3.

  • Biopsy ...

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