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2019 | OriginalPaper | Hoofdstuk

30. Vulvar cancer and vulvar premalignancies

Auteurs : Dr Joanne A. de Hullu, Dr Irene A. M. van der Avoort, Dr Maaike H. M. Oonk, Dr Mariette I. E. van Poelgeest

Gepubliceerd in: Textbook of Obstetrics and Gynaecology

Uitgeverij: Bohn Stafleu van Loghum

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Summary

Vulvar malignancies are rare with squamous cell carcinoma (SCC) as the most common histological type. Vulvar basal cell carcinomas and melanomas are even more rare. In general, vulvar cancer is a disease of the elderly woman but the incidence is increasing, especially in younger women. There are two oncogenic pathways of vulvar SCCs, both with their own premalignancy, but with comparable treatment until now. Surgery is the cornerstone of treatment consisting of excision of the primary tumour with groin surgery. This leads to a 5-year survival rate of around 70 %. The treatment of vulvar cancer has an enormous impact on the psychosexual quality of life. Lichen sclerosus, vulvar high-grade squamous intra-epithelial lesion (HSIL), differentiated vulvar intraepithelial neoplasia (dVIN) and Paget’s disease of the vulva are all vulvar premalignancies with a broad spectrum of symptoms. Dedicated multidisciplinary teams are necessary to optimize cure and care for women with vulvar cancer and vulvar premalignancies.
Woordenlijst
Vulva
The vulva consists of the female external genitalia. The main structures of the vulva are: the mons pubis, the labia majora and minora, the external part of the clitoris (hood, glans), the urinary meatus, the vaginal opening and hymen, and the vestibular glands
Squamous cell carcinomas
Also known as epithelial carcinomas, are a number of different types of cancer that result from squamous cells. These cells form the surface of the skin
Premalignancy
A premalignancy is a premalignant condition, sometimes called a potentially precancerous condition: a state of disordered morphology of cells that is associated with an increased risk of cancer. If left untreated, these conditions may lead to cancer
Human papillomavirus
A small DNA virus of which over 150 types are known and can be transmitted through sexual contact. Although most HPV infections do not cause any symptoms and resolve spontaneously, persistent infections can result in warts and (pre)cancerous lesions of the genitals and throat
CO2 lasers
May be used to treat certain skin conditions. CO2 lasers can be used in place of a scalpel for most procedures, especially in delicate areas where mechanical trauma could damage the surgical site. Advantages include less bleeding, shorter surgery time, less risk of infection, and less postoperative swelling
Vaccination
The administration of antigens (a vaccine) to stimulate an individual’s immune system to develop immunity to a certain pathogen. Prophylactic vaccination is aimed at prevention, whereas therapeutic vaccination is aimed at the treatment of disease
Sentinel lymph node
Defined as the first draining lymph node in a lymphatic basin that receives primary lymph flow from a tumour. In case of established cancerous dissemination it is postulated that the sentinel lymph node/s is/are the target organs primarily reached by metastasizing cancer cells from the tumour
Bartholin’s glands
Two pea-sized compound glands located slightly posterior and to the left and right of the opening of the vagina. They secrete mucus to lubricate the vagina and are homologous to bulbourethral glands in males
Literatuur
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Metagegevens
Titel
Vulvar cancer and vulvar premalignancies
Auteurs
Dr Joanne A. de Hullu
Dr Irene A. M. van der Avoort
Dr Maaike H. M. Oonk
Dr Mariette I. E. van Poelgeest
Copyright
2019
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-368-2131-5_30