gynecology and obstetrics
Vulvar Cancer
Diagnosis of Vulvar Cancer
Biopsy Vulvar cancer may mimic sexually transmitted genital ulcers (eg, Chancroid ), A dermal punch biopsy using a local anesthetic is usually diagnostic. Occasionally, wide local excision is necessary to differentiate VIN from cancer. Subtle lesions may be delineated by staining the vulva with toluidine blue or by using colposcopy. If a vulvar lesion develops in a woman at low risk of sexually transmitted infections (STIs) or does not respond to treatment for STIs, evaluate for vulvar cancer. Staging of vulvar cancer is based on tumor size and location and on regional lymph node spread as determined by lymph node dissection or sentinel lymph node (SLN) biopsy done as part of initial surgical treatment (see table). 