Overview

• Malignant neoplasm of the vulva → 80% are squamous cell carcinoma.
• Most cases in women >75 years old.
• Risk Factors → HPV, vulval intraepithelial neoplasia (VIN), immunosuppression, lichen sclerosus.

Making Diagnosis

Clinical Features

• Lump or ulcer on labia majora (most common area affected).
• Inguinal lymphadenopathy.
• May have associated itching and irritation.

<aside> 💡 Persistent unexplained vulval skin lesion (lump or ulceration) → 2ww referral.

</aside>

Investigations

• Tissue diagnosis → biopsy.
• Cervical smear.
• Imaging → CT or MRI to assess lymphadenopathy.
• Staging
  • Stage 1 → tumour confined to vulva.
  • Stage 2 → spread to nearby parts (lower vagina, anus or urethra).
  • Stage 3 → spread into nearby lymph nodes.
  • Stage 4 → spread to more distant lymph nodes.

Management Plan