Squamous vulval cancer–an update



Key content

  • Squamous vulval cancer is a rare condition with a poorly understood aetiology. Two factors seem to have an important role; infection with human papilloma virus leading to vulva intraepithelial neoplasia and chronic inflammatory vulval dermatoses such as lichen sclerosus.
  • Diagnosis based on biopsy and management is complex. Consideration is given to site and size of lesion as well as the FIGO staging system.
  • Depending on the stage of cancer, other treatment modalities such as chemoradiation may play a role in the management of the condition.

Learning objectives

  • To know how to perform an incisional biopsy of a suspicious vulval lesion.
  • To acknowledge that incisional biopsy is the preferred mode of diagnosis for vulval cancer and appreciate that the role of wide local excision is limited.
  • To be aware of the use of sentinel node biopsy in the management of vulval cancer.
  • To understand that reconstructive surgery has an important place in the management of these patients.

Ethical issue

  • How can health professionals help women cope with the psychosexual sequelae after vulval surgery?