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VV Cancers

This document discusses vulvar and vaginal cancers. It provides information on the relevant anatomy, epidemiology, risk factors, diagnosis, staging, prognosis, treatment, and surveillance of vulvar cancer. It discusses types of vulvar cancer including recurrent disease, verrucous carcinoma, melanoma, and others. For vaginal cancer, it provides information on relevant anatomy, incidence, types including squamous cell carcinoma, adenocarcinoma, and mesenchymal tumors such as melanoma.

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Azadov
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14 views

VV Cancers

This document discusses vulvar and vaginal cancers. It provides information on the relevant anatomy, epidemiology, risk factors, diagnosis, staging, prognosis, treatment, and surveillance of vulvar cancer. It discusses types of vulvar cancer including recurrent disease, verrucous carcinoma, melanoma, and others. For vaginal cancer, it provides information on relevant anatomy, incidence, types including squamous cell carcinoma, adenocarcinoma, and mesenchymal tumors such as melanoma.

Uploaded by

Azadov
Copyright
© © All Rights Reserved
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Islamic Imarats of Afghanistan

Ministry of public health


Parwan Hospital
Obstetrics and gynecology department

Vulvar Cancer
Vaginal Cancer
By : Basira Mansoori
 Relevant Anatomy
 Epidemiology
 Risk factors
 Diagnosis
 Staging
 Prognosis
 Treatment
 Surveillance

Vulvar Cancer
 RECURRENT DISEASE
 VERRUCOUS CARCINOMA
 MELANOMA
 Metastatic Disease
 BASAL CELL CARCINOMA
 VULVAR SARCOMA
 VULVAR PAGET DISEASE
 Bartholin GLAND CARCINOMA
 VULVAR PAGET DISEASE
 CANCER METASTATIC TO The VULVA
The vulva includes the mons pubis, labia major and minor,
Relevant clitoris, vestibule, vestibular bulbs, Bartholin glands, lesser
vestibular glands, Para urethral glands, and the urethral and
Anatomy vaginal openings.
Relevant
Anatomy
Of vulvar tumors, approximately 90 percent are squamous cell

Epidemiology carcinoma . Malignant melanoma is the second most common, but


rare histologic subtypes may also be considered.
Risk factors
Age is a prominent factor and positively correlates with this
cancer.
These cancers are usually described histologically as basaloid or
warty and are linked with human papillomavirus (HPV).
Herpes simplex virus infection is also linked with vulvar cancer in
several studies .
Chronic immunosuppression can predispose to vulvar cancer.
Lichen sclerosus is a chronic vulvar infammatory disease and is
related to vulvar cancer development.
Symptoms :
Women with VIN and vulvar cancer commonly present with
pruritus and a visible lesion However, pain, bleeding, ulceration,
Diagnosis or inguinal mass may be other complaints. Manifestations can
persist for weeks or months before diagnosis, as many patients
may be embarrassed or may not recognize the significance to
their symptoms.
Lesions may be raised, ulcerated, pigmented, or warty, but in
younger women with multi focal disease, as well-defined mass is
Lesion not always present.

Evaluation For this, colposcopic examination o the vulva, termed


vulvoscopy, can direct biopsy site selection.
The International Federation of Gynecology and Obstetrics
(FIGO) advocates surgical staging of patients with vulvar
Staging cancer that is based on a tumor, nodal, metastatic ( TNM)

Systems calcinations. Thus, staging involves: (1) primary tumor


resection to obtain tumor dimensions and (2) dissection o
superficial and deep inguinofemoral lymph nodes to evaluate
tumor spread.
Overall survival rates of women with squamous cell carcinoma
of the vulva are relatively good.
Apart rom FIGO stage, other important prognostic factors
include lymph node metastasis, lesion size, depth of invasion,
PROGNOSIS resected-mar-gin status, and lymphatic vascular space
involvement (LVSI).
Of these, lymph node metastasis is the single most important
vulvar cancer predictor.
Surgery :
For vulvar cancer treatment, surgery is often an integral part.
Treatment Potential procedures, in increasing order of radicality, include
wide local excision (WLE), radical partial vulvectomy, and rad-
ical complete vulvectomy.
Inguinofemoral This procedure is usually an integral part o surgical cancer

Lymphadenecto staging and accompanies radical partial or radical complete


vulvectomy.
my
As another less morbid option, selective dissection of a solitary

Sentinel Lymph node or nodes, termed sentinel lymph node biopsy (SLNB).

Node Biopsy Physiologically, the first lymph node to receive tumor lymphatic
drainage is termed the sentinel lymph node.
After completing primary treatment, all patients receive thorough
physical examination, including inguinal lymph node palpation
and pelvic examination.
SURVEILLAN Vulvoscopy and biopsies are performed if concerning areas are
CE noted during history or physical examination. Radiologic imaging
and biopsies to diagnose possible tumor recurrence are performed
as indicated.
RECURRENT Vulvar Recurrences

DISEASE Distant Recurrences


VERRUCOUS This rare variant of squamous cell carcinoma constitutes less than
1 percent of all vulvar cancers.
CARCINOMA
Melanoma is the second most common vulvar cancer and
MELANOMA accounts or 10 percent of all vulvar malignancies.
Basal cell carcinoma (BCC) of the vulva accounts or <2 percent
BASAL CELL of all vulvar cancers and is most commonly found in elderly
CARCINOMA women .
Sarcoma of the vulva is rare, and leiomyosarcoma, malignant
fibrous histiocytoma, epithelioid sarcoma, and malignant
VULVAR rhabdoid tumor are the more requently encountered histologic

SARCOMA types.
Of these, leiomyosarcoma appears to be most common.
VULVAR Extramammary Paget disease is a heterogeneous group of

PAGET intraepithelial neoplasias and when present on the vulva, appears


as an eczematoid, red, weeping area .
DISEASE
Metastatic tumors make up approximately 8 percent of all vulvar
CANCER cancers.

METASTATIC Tumors may extend from primary cancers of the bladder,

TO ThE urethra, vagina, or rectum. Less proximate cancers include those


from the breast, kidney, lung, stomach, and gestational
VULVA choriocarcinoma .
Relevant Anatomy
Incidence
Squamous cell carcinoma
Vaginal Cancer Adenocarcinoma
Mesynchymal Tumors
Melanoma
During embryogenesis, the müllerian ducts fuse caudally to form
Relevant the uterovaginal canal The canal’s distal portion forms the
proximal vagina, whereas the distal vagina arises from the
Anatomy urogenital sinus .
Vaginal cancer rates increase with age and peak among women
≥80 years. The median age at diagnosis is 58.
Incidence Of histologic forms, squamous cell carcinoma accounts for 70
to 80 percent of all primary vaginal cancer cases .
Risks
SQUAMOUS Diagnosis
CELL Staging
CARCINOMA Prognosis

1 Treatment
Primary adenocarcinoma of the vagina is rare, making up only 13
percent of all vaginal cancers. Histologic types include clear cell,
ADENOCARC endometrioid, mucinous, and serous carcinoma, and these may
INOMA arise in endometriosis foci, in areas of vaginal adenosis, in
periurethral glands, or in wolfan duct rem-nants.
Clear Cell Of primary vaginal adenocarcinomas, the clear cell type is most
Adenocarcinom closely associated with DES exposure .

a
Embryonal Rabdomyosarcoma :
MESENChYM
AL TUMORS This is the most common malignancy of the vagina in infants and
children, and most embryonal rhabdomyosarcomas are the
sarcoma botryoides subtype.
This is the most common type of vaginal sarcoma in adults.
Leiomyosarco However, it makes up no more than 1 percent of vaginal
malignancies, and only 140 cases have been described in the
ma literature to date .
Primary malignant melanoma in the vagina is rare, accounting for

MELANOMA less than 3 percent of all vaginal cancers. In women, only 1.6
percent o melanomas are genital
Thanks

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