Vulvar Cancer

  • Stephen Shiao
  • Brian Missett
  • Joycelyn L. Speight


Anatomy = mons pubis, clitoris, labia majora, labia minora, vaginal vestibule, Bartholin’s glands (at posterior labia majora), prepuce over clitoris, posterior forchette, perineal body. Most common presenting symptoms = pruritis, pain, and/or a palpable mass. Approximately 70% arise in the labia and ∼15% arise in the clitoris or perineal body. LN spread is to inguino-femoral nodes (superficial and deep). Most superior deep femoral node = Cloquet’s node. Clitoris can theoretically drain directly to pelvic LN, but rare without inguino-femoral LN involvement. Risk factors = HPV 16, 18, 33 (condyloma acuminatum), vulvar intraepithelial neoplasia (2–5% progress to CA), Bowen’s disease, Paget’s disease, erythroplasia, chronic irritant vaginitis (e.g., with pessary), leukoplakia, employment in laundry and cleaning industry, smoking. Risk of nodal involvement correlates with stage and depth of tumor invasion: IA <1 mm deep <5%, 1–3 mm deep 8–10%, 3–5 mm deep 20% More than 5 mm deep or >2 cm size 40% III 30–80% IV 80–100% Approximately 20–25% of cN0 patients are pN+. If inguinal LN+, ∼30% risk of pelvic LN+.


Condyloma Acuminatum Vulvar Cancer Perineal Body Vulvar Intraepithelial Neoplasia Inguinal Lymphadenectomy 
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Copyright information

© Springer-Verlag New York 2010

Authors and Affiliations

  • Stephen Shiao
    • 1
  • Brian Missett
    • 2
  • Joycelyn L. Speight
    • 3
  1. 1.Radiation OncologyUniversity of California San FranciscoSan FranciscoUSA
  2. 2.Radiation OncologyKaiser Permanente Santa ClaraSanta ClaraUSA
  3. 3.Board Certified Radiation OncologistSan FranciscoUSA

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