Vulvar cancer is relatively rare (1-2%) compared with its localization in other female genital organs. Initially, a thickening (nodule) appears on the skin of the vulva, which does not bother the patient. Then itching, a sore with dense edges, spreading inland and in breadth, appears. Discharges, bleeding, and often pain appear, especially with irritation of an ulcer by urine. If the cancerous infiltrate is located near the urethra, the latter is compressed, urinary retention or frequent urination occurs. Vulvar cancer often gives metastases to various organs: the inguinal lymph nodes and nodes in the pelvic cavity (iliac and hypogastric), the bladder, rectum, and very rarely the vagina. research, biological reactions to the content of chorionic gonadotropin in the urine and hormonal research methods). Histologically, vulvar cancer is a squamous cell carcinoma with a tendency to keratinization, less often the glandular tumor form. The tumor may take the form of a dense node, cartilage consistency, papillary growths such as cauliflower, a crater-like ulcer with an infiltrative base and uneven flat edges. Stage of prevalence: I – a tumor up to 2 cm in diameter is localized in the surface layers of the vulva; II – a larger surface tumor or a tumor with infiltration of the underlying tissue and mobile metastases in the inguinal lymph nodes; III – a motionless tumor with deep infiltration of the underlying tissues, metastases to the inguinal lymph nodes; IV – tumor spread to neighboring organs, metastases to distant organs. In advanced cases, the entire vulva is affected. Lastly, the urethra is involved in the process. Frequent and rapid metastasis in vulvar cancer is due to the richly developed lymphatic network of the external genitalia and the presence of wide lymphatic connections with other pelvic organs.
Vulvar Cancer Clinic
Vulvar cancer most often develops after 50 years, i.e., in the period of menopause, against the background of leukoplakia and kraurosis. At the same time, itching of the vulva is noted for a long time, then burning, whitening, spotting, pain join in. With the addition of a pyogenic infection and the decay of the tumor, the whites take a purulent character, sometimes with a fetid odor. Insomnia, weakness, malaise, fatigue, emaciation are noted. In advanced cases and with ineffective treatment, death quickly occurs from cancer cachexia, urosepsis, pelvic thrombophlebitis or bleeding, especially with clitoral cancer.
Diagnosis of vulvar cancer
The diagnosis of vulvar cancer is established upon examination. The tumor must be differentiated from tuberculous and syphilitic ulcer of the vulva. To clarify the diagnosis, a cytological examination is performed (the material is obtained by the contact glass method) and a biopsy.
Vulvar Cancer Treatment
Treatment of a tumor in the early stages should be comprehensive. Surgical treatment (vulvectomy with removal of inguinal lymph nodes) in stage I-II vulvar cancer. After surgery, radiation therapy is prescribed. In case of an inoperable tumor, application radiotherapy (application of radioactive cobalt) with X-ray of the inguinal lymph nodes is prescribed. Recently, many authors recommend a cryosurgical method for removing the tumor. The prognosis for stage I-II vulvar cancer is relatively favorable, and III-IV is unfavorable.
Prevention is the early detection and timely treatment of precancerous diseases of the vulva.
Benign Vulvar Tumors
Benign vulvar tumors are rare. They can appear at any age. Squamous cell papilloma is usually a single small formation in the form of a papilla formed by layers of squamous epithelium. In these cases, it is necessary to exclude genital warts, which are most often multiple. Fibroma develops from the connective tissue of the labia majora. A fibroepithelial polyp is a small formation consisting of excess skin, including the dermis, which may be on the leg. Myoma is a tumor of muscle fibers of the round ligament ending in the labia majora. Lipoma is a tumor emanating from the adipose tissue of the pubis and the labia majora. Hydroadenoma develops from apocrine sweat glands, is located in the thickness of the labia majora in the form of single or multiple nodules. In extremely rare cases, myxomas, neurofibromas, and vascular vulvar tumors are found. The forecast is favorable. Surgical treatment.