Vulvar Cancer

What is vulvar cancer?

Vulvar Cancer is cancer to a portion of the female sexual organ, the area of the vulvar .

  • incidence in the Netherlands 2 per 100,000 women
  • 200 / yr new tumors diagnosed
  • death about 70 women a malignant tumor vulvar.
  • peak incidence in elderly patients (54% over 70 years, 15% under 50 years) and represent more than 70% of cases a squamous carcinoma. Malignant melanomas and adenocarcinomas are found relatively more often in younger women.

Types of vulvar tumors

  • squamous cell carcinoma (90%);
  • basal cell carcinoma;
  • verrucosum carcinoma;
  • adenocarcinoma;
  • malignant melanoma (5%);
  • sarcoma;
  • metastasis (from uterine cervix, endometrium and vagina, adenocarcinoma of the kidney).

Vulvar cancer prognosis

Prognosis depends on the local expansion (diameter, T status) and lymph node metastasis (N status) are most important. When the state of the vulvar carcinoma lymph node metastasis to the inguinal glands in the foreground, and thence to the pelvic glands. Approximately 30% of patients with a vulvar carcinoma metastases has glands in the groin. Especially patients with multiple lymph node metastases, bilateral occurrence of these metastases and / or style of the breakthrough kliermetastase have a poor prognosis. 5-year survival: Stage I: 90%; Stage II: 80%; Stage III: 70%; Stage IV: 25%

 is cancer to a portion of the female sexual organ Vulvar Cancer

Vulvar cancer symptoms

Symptoms of vulvar cancer or the pre-stages are:
  • prolonged itching or burning sensation
  • the thickening of the skin of the vulva
  • change in pigmentation or poorly healing open wound
  • bloody discharge


  • Physical examination: Malignant tumors of the vulva are most common on the labia majora and minora. The tumor can arise multi-centric. In a number of cases, will be a "kissing ulcer" for.
  • Research in anesthesia: For larger tumors in anesthesia research in a multidisciplinary context with possibly urethrocysto- & / or rectoscopy.
  • Laboratory tests: routine (preoperative) blood and urine tests.
  • Imaging: chest radiograph (distant?); CT / MRI Abdomen + pelvis at ≥T3 & / or palpable abnormalities in the groin (pelvic lymphadenopathy ?, if so then CT guided biopsy of glands); urethrocysto- / rectoscopy on display (through growth?).

Vulvar cancer treatment
  • Surgery (OK)
  • Radiotherapy (RTX)
  • Chemotherapy (CTX)

In general, surgery is the treatment of choice at the 1st vulva carcinoma, optionally combined with radiotherapy and / or chemotherapy.


  • Recurrences and distant metastases occur almost always within 2-3 years after surgery.
  • Local recurrence after treatment to cure again. For a groin recurrence and distant recurrence especially for a cure in these are much smaller. Local recurrence is at 15-30% of patients, often after many years. Local recurrence after> 5 years after primary treatment occurring, should probably be regarded as a second tumor.
  • The probability of a second vulva carcinoma is approximately 10%. Also, there is an increased likelihood of ( pre ) malignant abnormalities of the cervix and vagina.
  • Control Scheme: 1st Control: 6wkn after discharge; 1st & 2nd year: 1x / 3mnd; 3rd & 4th year: 1x / 6mnd; 5th year & then 1x / yr life; during inspection visits focused history and physical examination.

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