Vulvar cancer
Vulvar cancer
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Vulvar cancer

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Vulvar cancer

Vulvar cancer is a cancer of the vulva, the outer portion of the female genitals. It most commonly affects the labia majora. Less often, the labia minora, clitoris, or Bartholin's glands are affected. Symptoms include a lump, itchiness, changes in the skin, or bleeding from the vulva.

Risk factors include vulvar intraepithelial neoplasia (VIN), HPV infection, genital warts, smoking, and many sexual partners. Most vulvar cancers are squamous cell cancers. Other types include adenocarcinoma, melanoma, sarcoma, and basal cell carcinoma. Diagnosis is suspected based on physical examination and confirmed by tissue biopsy. Routine screening is not recommended.

Prevention may include HPV vaccination. Standard treatments may include surgery, radiation therapy, chemotherapy, and biologic therapy. Vulvar cancer newly affected about 44,200 people and resulted in 15,200 deaths globally in 2018. In the United States, it newly occurred in about 6,070 people with 1,280 deaths a year. Onset is typically after the age of 45. The five-year survival rate for vulvar cancer is around 71% as of 2015. Outcomes, however, are affected by whether spread has occurred to lymph nodes.

The signs and symptoms can include:

Typically, a lesion presents in the form of a lump or ulcer on the labia majora and may be associated with itching, irritation, local bleeding or discharge, in addition to pain with urination or pain during sexual intercourse. The labia minora, clitoris, perineum and mons pubis are less commonly involved. Due to modesty or embarrassment, people may put off seeing a doctor.

Melanomas tend to display the typical asymmetry, uneven borders, and dark discoloration, as do melanomas in other parts of the body.

Adenocarcinoma can arise from the Bartholin's gland and present with a painful lump.

Two main pathophysiological pathways are currently understood to contribute to the development of vulvar cancer: human papillomavirus (HPV) infection and chronic inflammation or autoimmunity affecting the vulvar area.

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