gynecology and obstetrics
Vulvar Cancer
Key Points
Most vulvar cancers are squamous cell carcinomas; approximately 5% are melanomas. Consider vulvar cancers if vulvar lesions, including pruritic lesions and ulcers, do not respond to treatment for STIs or the lesions occur in women at low risk of STIs. Diagnose vulvar cancer by biopsy, and stage it surgically. For cancers without distant metastases, use wide local excision, and unless stromal invasion is < 1 mm, do lymph node dissection or sentinel lymph node biopsy. For cancers with lymph node or distant metastases, treat with a combination of surgery, radiation therapy, and/or chemotherapy. 