Common symptoms are irritation or itching of the vulva, the presence of a tumor, non-healing ulcers, and pain in the vulva, which are long-term relapsing and persistent. About half of patients with vulvar cancer complain of constant and increasing itching in this area. Less commonly, the first manifestations of the disease are bloody or purulent discharge, an increase in inguinal lymph nodes. The clinical manifestations of vulvar cancer depend on the background on which the disease developed. If vulvar cancer was not preceded by non-tumorous dystrophic processes, then in the early stages the symptoms of the disease are weakly expressed: first there is discomfort (itching, burning), and then a small ulcer forms. As the disease progresses, the severity of symptoms increases. When the underlying tissues are infiltrated, pain appears in the perineum, pain and burning sensation during urination, especially when there is an infiltration of the external opening of the urethra. The formation of a tumor of significant size leads to the appearance of copious • fetid discharge; bleeding may occur. With the development of vulvar cancer against the background of non-tumor dystrophic processes, the leading symptom is itching, which is paroxysmal in nature and intensifies at night.
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The first symptoms of vulvar cancer directly depend on the location of the tumor and the form of its growth. The most frequent localization is on the labia majora. Next, the frequency of the lesion is followed by the labia minora. Significantly less often, the primary localization is the clitoris, urethra and perineum. Forms of growth characteristic of vulvar cancer are exo- and endophytic tumors, ulcerative neoplasms. Tumors that have infiltrative growth with an edematous component and an extremely aggressive clinical course are observed much less frequently. The appearance of distant hematogenous metastases in the lungs, liver, and bones is possible. In the vast majority of cases, locally common forms of squamous cell carcinoma of the vulva are diagnosed.
Diagnosis of vulvar cancer
A gynecological examination, simple and advanced vulvoscopy are performed, cytological, morphological (tumor biopsy and puncture biopsy of the inguinal lymph nodes), bacterioscopic and bacteriological methods are used.
To clarify the degree of spread of the tumor, an X-ray examination of the chest (detection of metastases in the lungs) and ultrasound methods (assessment of the state of the lymph nodes) are used. According to indications, urethro- and cystoscopy, excretory urography, radionuclide examination of the kidneys, sigmoidoscopy, computed tomography, radionuclide lymphography are used. If necessary , a biopsy of the mucous membrane of the bladder and / or rectum is performed.