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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.
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Squamous cell carcinomas
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
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
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
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
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- Vulvar cancer and vulvar premalignancies
Dr Joanne A. de Hullu
Dr Irene A. M. van der Avoort
Dr Maaike H. M. Oonk
Dr Mariette I. E. van Poelgeest
- Bohn Stafleu van Loghum