Vulval Carcinoma

  • Rajeev ShahEmail author
  • Aaron Ervine


Vulval Carcinoma: this chapter outlines the incidence, risk factors, clinical presentation, investigations, treatments and prognosis of cancer at this anatomical site. These features are correlated with the core data that are required to make corresponding histopathology reports of a consistently high quality, available in an appropriate timeframe, and clinically relevant to patient management and prognosis. Summary details of the common cancers given at this site include: gross description, histological types, tumour grade/differentiation, extent of local tumour spread, lymphovascular invasion, lymph node involvement, and the status of excision margins. Current WHO Classifications of Malignant Tumours and TNM8/FIGO are referenced. Notes are provided on other associated pathology, contemporary use of immunohistochemistry, updates on the role of evolving molecular tests, and the use of these ancillary techniques as biomarkers in diagnosis, and prediction of prognosis and treatment response. A summary is given of the more common non-carcinoma malignancies that are encountered at this site in diagnostic practice.


Squamous cell carcinoma Paget’s disease Lichen sclerosus HPV FIGO 


  1. Del Pino M, Rodriguez-Carunchio L, Ordi J. Pathways of vulvar intraepithelial neoplasia and squamous cell carcinoma. Histopathology. 2013;62:161–75.CrossRefGoogle Scholar
  2. Fox H, Wells M, editors. Haines and Taylor. Obstetrical and gynaecological pathology. 5th ed. London: Churchill Livingstone; 2003a.Google Scholar
  3. Fox H, Wells M. Recent advances in the pathology of the vulva. Histopathology. 2003b;42:209–16.CrossRefGoogle Scholar
  4. Heatley MK. Dissection and reporting of the organs of the female genital tract. J Clin Pathol. 2008;61:241–57.CrossRefGoogle Scholar
  5. Herrington CS. Recent advances in molecular gynaecological pathology. Histopathology. 2009;55:243–9.CrossRefGoogle Scholar
  6. Hirschowitz L, Nucci M, Zaino RJ. Problematic issues in the staging of endometrial, cervical and vulval carcinomas. Histopathology. 2013;62:176–202.CrossRefGoogle Scholar
  7. Kurman RJ, Norris HJ, Wilkinson E. Tumors of the cervix, vagina and vulva, Atlas of tumor pathology, vol. 3. Washington, DC: AFIP; 1992.Google Scholar
  8. McAlpine JN, Leung SC, Cheng A, Miller D, Talhouk A, Gilks CB, et al. Human papillomavirus (HPV)-independent vulvar squamous cell carcinoma has a worse prognosis than HPV- associated disease: a retrospective cohort study. Histopathology. 2017;71:238–46.CrossRefGoogle Scholar
  9. McCluggage WG. Recent developments in vulvovaginal pathology. Histopathology. 2009;54:156–73.CrossRefGoogle Scholar
  10. McCluggage WG. Ten problematic issues identified by pathology review for multidisciplinary gynaecological oncology meetings. J Clin Pathol. 2012;65:293–301.CrossRefGoogle Scholar
  11. McCluggage WG, Hirschowitz L, Ganesan R, Kehoe S, Nordin A. Which staging system to use for gynaecological cancers: a survey with recommendations for practice in the UK. J Clin Pathol. 2010;63:768–70.CrossRefGoogle Scholar
  12. Nucci MR, Fletcher CDM. Vulvovaginal soft tissue tumours: update and review. Histopathology. 2000;36:97–108.CrossRefGoogle Scholar
  13. Pecorelli S, FIGO Committee on Gynecologic Oncology. Revised FIGO staging for carcinoma of the vulva, cervix and endometrium. Int J Gynecol Obstet. 2009;105:103–4.CrossRefGoogle Scholar
  14. Robboy SJ, Bentley RC, Russell R, Anderson MC, Mutter GL, Prat J. Pathology of the female reproductive tract. 2nd ed. London: Churchill Livingstone Elsevier; 2009.Google Scholar
  15. Stewart CJR, McCluggage WG. Epithelial-mesenchymal transition in carcinomas of the female genital tract. Histopathology. 2013;62:31–43.CrossRefGoogle Scholar
  16. Tavassoli F, Devilee P, WHO Classification of Tumours. Pathology and genetics. Tumours of the breast and female genital organs. Lyon: IARC Press; 2003.Google Scholar
  17. The Royal College of Pathologists. Cancer datasets (vulval neoplasms, cervical neoplasia, endometrial cancer, uterine sarcomas, neoplasms of the ovaries and fallopian tubes and primary carcinoma of the peritoneum), and tissue pathways for gynaecological pathology. 2015.
  18. Wakeham K, Kavanagh K, Cuschieri K, Millan D, Pollock KG, Bell S, et al. HPV status and favourable outcome in vulvar squamous cancer. Int J Cancer. 2017;140:1134–46.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Cellular PathologyCraigavon Area HospitalCraigavonUK

Personalised recommendations