Overview
Vulvar cancer arises from the skin and mucosa of the external female genitalia, most commonly as squamous cell carcinoma.
It often presents with itching, a persistent sore, or a visible lump; early diagnosis allows less extensive surgery and better functional results.
Management is stage- and site-specific, emphasising oncologic clearance while preserving sexual, urinary and cosmetic outcomes.
Overview And Clinical Background
Pathology, HPV link and presentation
Most vulvar cancers are squamous cell carcinomas, with a subset linked to high-risk HPV and others associated with chronic dermatologic conditions like lichen sclerosus.
Age, sexual history, smoking and immune status influence risk and presentation.
- Histologic types: Squamous cell carcinoma is most common while adenocarcinoma, melanoma and basal cell types occur less frequently; subtype affects treatment and prognosis.
- Risk factors: HPV infection, chronic vulvar dermatoses, smoking, and immunosuppression increase the likelihood of malignant transformation and should trigger earlier evaluation of suspicious lesions.
- Clinical impact: Early recognition allows limited excision with sentinel node evaluation rather than radical vulvectomy, reducing morbidity while maintaining oncologic safety.
Symptoms, Signs And Presentation
Common symptoms include persistent vulvar itching, a sore that does not heal, a lump, or bleeding.
Patients and clinicians should not dismiss chronic vulvar symptoms as benign without appropriate assessment.
- Itching or irritation: Long-standing pruritus that fails to respond to standard topical therapy may herald malignant change and necessitates biopsy.
- Visible lesion: A persistent ulcer, lump, or discoloured patch on the vulva needs clinical photography and biopsy for histologic diagnosis.
- Local symptoms: Pain, bleeding, or dyspareunia (pain during intercourse) can occur as the tumor grows and should prompt urgent specialist review.
Diagnosis Methods And Investigations
Biopsy, imaging and nodal assessment
Diagnosis relies on targeted biopsy of suspicious vulvar lesions, with imaging used to assess local spread and nodal involvement.
Sentinel lymph node biopsy has become standard for many early lesions to reduce morbidity.
- Biopsy: Full-thickness incisional or excisional biopsy provides definitive histology and grading which are essential to staging and surgical planning.
- Imaging: Pelvic MRI and CT or PET-CT evaluate local extension and nodal/distant disease to guide the scope of surgery and need for adjuvant therapy.
- Nodal evaluation: Sentinel lymph node mapping and biopsy identify occult nodal disease and often replace routine groin dissection in selected early-stage patients to reduce complications.
Treatment Options And Surgical Techniques
Surgical management is central and ranges from local wide excision to radical vulvectomy with groin nodal treatment for advanced disease.
Reconstructive techniques and sentinel node strategies prioritise function and cosmesis.
- Wide local excision: For small, well-localised tumours, excision with clear margins preserves anatomy and function while providing oncologic control.
- Groin node management: Sentinel node biopsy or selective inguinal dissection is used based on tumour size and depth to stage disease accurately and guide adjuvant therapy.
- Adjuvant therapy: Radiotherapy and chemoradiation are used for positive margins, nodal disease, or advanced tumours to improve local control and survival.
Recovery, Risks And Prognosis
Recovery depends on extent of surgery; early-stage vulvar cancer treated with conservative surgery often has excellent outcomes with minimal long-term morbidity.
Advanced disease requires more complex reconstruction and rehabilitation but can still achieve meaningful disease control.
Why Choose Us
CureU Healthcare offers specialised vulvar cancer care including sentinel node expertise, reconstructive surgery, and dedicated sexual rehabilitation and psychosocial support.
We combine oncologic precision with attention to long-term function and quality of life.
Conclusion
Vulvar cancer is treatable and often curable when managed early by an experienced multidisciplinary team.
Don’t delay assessment of persistent vulvar symptoms — early biopsy saves tissue and function.
