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438 Carcinoma of vulva, case series

Objectives To analyze the clinical presentation and management outcomes of carcinoma of vulva managed at Civil Service Hospital, New Baneswor and National Cancer Hospital, Jawalakhel. Methods A descriptive study was conducted of all carcinoma of vulva cases managed from July 2014 to February 2019. The case records of all women diagnosed to have carcinoma of vulva were retrieved and socio-demographic characteristics, clinical presentations, histological type, treatment modalities and outcome were obtained and analyzed. Results There were 17 vulvar cancer patients during the study period. The ages ranged from 34 to 89 years (median age of 66 years). All of them were multiparous. Vulva wound and pruritus were the most frequent clinical features with presentations in stage I -52.9%, stage II- 17.6%, stage III – 17.6% and stage IV -11.7%. Squamous cell carcinoma 94.1% predominated and 5.9% cases had Basal cell carcinoma. Among the 17 cases, 94.1% were treated primarily with surgery, 5.9% with radiotherapy only while 47% with combined modality (Surgery and radiotherapy). Clinical follow-up of one to four years showed that 3 cases had local recurrence and 1died of disease. Conclusions Carcinoma of the vulva is a rare gynecological malignancy in Nepal. Surgery and radiotherapy remain to be the mainstay of treatment. Delayed presentation still result in greater morbidity and mortality rates.