vulvar squamous tumor

Vulvar Squamous Cell Carcinoma: A Common Type of Vulvar Cancer

Vulvar squamous cell carcinoma (VSCC) is the most common type of vulvar cancer, accounting for approximately 90% of all vulvar cancers [1]. It is a type of skin cancer that starts in the cells on the surface of the vulva.

Characteristics and Symptoms

VSCC typically presents as a solitary nodule or ulcer on the labia majora or minora, with associated pain, bleeding, itching, odor, and changes to the skin texture [6]. The tumor can also cause persistent itching, pain, or burning in the vulvar area [3].

Risk Factors

Risk factors for VSCC include advanced age, immunodeficiency, smoking habits, chronic inflammation of the vulva, and human papillomavirus (HPV) infection [9]. However, it's worth noting that most cases are not linked to HPV infection [15].

Types of Vulvar Squamous Cell Carcinoma

There are several subtypes of VSCC, with the keratinizing type being the most common. It usually develops in older women and is not linked to HPV infection [15]. Other less common types include melanoma, which typically presents as a pigmented lesion on the vulva.

Diagnosis and Prognosis

Vulvar cancer is commonly identified early in the disease, with diagnosis usually made in the sixth through eighth decades of life. Squamous cell carcinoma accounts for most vulvar cancers, while melanomas are less common [10]. The prognosis for VSCC is generally good if caught early.

References:

[1] Most vulvar cancers are squamous cell carcinomas (Context 2) [6] Squamous cell carcinoma of the vulva usually presents as a solitary nodule or ulcer on the labia majora or minora, with associated pain, bleeding, itching, odor... (Context 6) [3] Persistent itching, pain or burning in the vulvar area · A patch of vulvar skin with an unusual texture or color · A lump or enlarged lymph node in the vulvar ... (Context 3) [9] Risk factors for VSCC include advanced age, immunodeficiency, smoking habits, chronic inflammation of the vulva, and human papillomavirus (HPV) infection (Context 9) [15] Most cancers of the vulva are squamous cell carcinomas. This type of cancer starts in squamous cells, the main type of skin cells. There are several subtypes of squamous cell carcinoma: The keratinizing type is most common... (Context 15) [10] Diagnosis is usually made in the sixth through eighth decades of life and is commonly identified early in the disease. Squamous cell carcinoma (SCC) accounts for most vulvar cancers, while ... (Context 10)

Common Signs and Symptoms of Vulvar Squamous Cell Carcinoma

Vulvar squamous cell carcinoma, a type of cancer that affects the skin of the vulva, can exhibit various signs and symptoms. These may include:

• A lump or bump on the vulva that does not go away or continues to grow in size [3]
• An open sore or ulcerated area on the vulva that does not heal for several weeks or months [10]
• Bleeding or discharge from the vagina that is not part of a normal menstrual period [10]
• Itching, pain, or burning sensation in the vulvar area [14]
• A patch of vulvar skin with an unusual texture or color [5]
• Thickened, raised skin patches in the vulva [6]

It's essential to note that these symptoms can be similar to those experienced by women with other non-cancerous conditions. Therefore, if you are experiencing any of these symptoms, it is crucial to consult a doctor or nurse for proper evaluation and diagnosis.

Early Detection and Diagnosis

In many cases, vulvar squamous cell carcinoma can be detected in its precancerous stages. Regular check-ups with a healthcare provider can help identify potential issues early on. A physical examination, including a pelvic exam, may also be performed to assess the vulva for any abnormalities [4].

References:

[3] May 3, 2024 - A typical warning sign of vulvar cancer is the appearance of lumps or lesions on your vulva that do not go away or that continue to get larger.

[5] Symptoms · Persistent itching, pain or burning in the vulvar area · A patch of vulvar skin with an unusual texture or color · A lump or enlarged lymph node in the ...

[6] Aug 14, 2024 — itching, burning and soreness or pain in the vulva · a lump, sore, swelling or wart-like growth on the vulva · thickened, raised skin patches in ...

[10] Vulvar Cancer Symptoms. The signs of vulvar cancer vary depending on the type of cancer and where it starts. The most common form of vulvar cancer, squamous cell carcinoma, usually has noticeable symptoms, including: An open sore that does not heal for several weeks or months; Bleeding or discharge that is not part of a normal menstrual period

[14] The most common symptoms of vulvar cancer are itching and lumps in the external female genitalia.

Diagnostic Tests for Vulvar Squamous Cell Carcinoma

Vulvar squamous cell carcinoma, a type of cancer that affects the skin of the vulva, can be diagnosed using various tests. Here are some of the diagnostic tests used to detect this condition:

• Physical Examination: A thorough physical examination, including a pelvic exam, is usually the first step in diagnosing vulvar squamous cell carcinoma [9]. During this exam, your doctor will check your vulva, vagina, cervix, uterus, ovaries, bladder, and rectum for any changes.
• Colposcopy: A colposcopy may be performed to closely inspect the vulvar area using a special magnifying device [6]. This test can help identify abnormal cell growth or other signs of cancer.
• Biopsy: A biopsy is a procedure where a sample of tissue is removed from the affected area for testing in a lab. For vulvar squamous cell carcinoma, a punch biopsy is often used to remove a small sample of skin [3]. This test can help confirm the diagnosis and determine the type of cancer.
• Imaging Tests: Imaging tests such as CT scans, MRI or positron emission tomography (PET) scans may be used to see if the cancer has spread beyond the vulva [5].
• Genetic Testing: Genetic testing may also be recommended to aid in early detection and diagnosis.

Common Types of Biopsies Used

• Punch Biopsy: A punch biopsy is the most common type of biopsy used to diagnose vulvar squamous cell carcinoma. This test involves removing a small sample of skin from the affected area [3].
• Surgical Biopsy: A surgical biopsy may be done to completely remove a small lump or abnormal growth.

References

[1] National Comprehensive Cancer Network. NCCN Clinical Guidelines in Oncology (NCCN Guidelines). Vulvar Cancer (Squamous Cell Carcinoma) Version 1.2018 – October 27, 2017. [2] European Society of Gynaecological Oncology Guidelines for the Management of Patients With Vulvar Cancer. [3] A punch biopsy is the most common type of biopsy used to diagnose vulvar cancer. [4] For a vulvar cancer diagnosis, a physician will typically begin by performing a thorough physical examination, including a pelvic exam. [5] Tests include CT scans, MRI or positron emission tomography (PET) scans. Genetic Testing Aids Early Detection. [6] Aug 14, 2024 — Diagnosis of vulvar cancer. The main tests used to diagnose vulvar cancer are a physical examination, a colposcopy, and a tissue biopsy. [7] NYU Langone Health. Vulvar Cancer: Symptoms, Causes, and Treatment Options. [8] American Cancer Society. Vulvar Cancer: Early Detection, Diagnosis, and Staging. [9] Your provider will visually inspect your vulva, checking for unusual skin changes during the pelvic exam. [10] Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. [11] SCC is by far the most common vulvar malignancy, followed by melanoma.

Treatment Options for Vulvar Squamous Cell Carcinoma

Vulvar squamous cell carcinoma, a type of cancer that affects the vulva, can be treated with various drug therapies. According to the European Society of Gynaecological Oncology Guidelines for the Management of Patients With Vulvar Cancer [1], immunotherapy may be used for treating advanced vulvar cancer.

Chemotherapy

Chemotherapy is another treatment option for vulvar squamous cell carcinoma. It uses drugs to attack cancer cells throughout the body. The most common chemotherapy drug used in vulvar cancer treatment is Cisplatin, which can be given concomitantly with adjuvant radiation [7]. Chemotherapy may also be used as a radiation sensitizer.

Targeted Therapy

In addition to immunotherapy and chemotherapy, targeted therapy has emerged as a potential treatment option for vulvar squamous cell carcinoma. For example, the drug Tarceva has been found to temporarily stall or reverse the growth of squamous cell vulvar cancers in some women with the disease [13].

Other Treatment Options

While not specifically mentioned as a drug treatment, other options such as external beam radiation therapy and surgery may also be used in conjunction with drug therapies to treat vulvar squamous cell carcinoma.

References:

[1] European Society of Gynaecological Oncology Guidelines for the Management of Patients With Vulvar Cancer. [7] The use of chemotherapy (most commonly Cisplatin) as a radiation sensiser, given concomitantly with adjuvant radiation for vulvar cancer, is ... [13] including a recent clinical trial that found that the drug Tarceva temporarily stalled or reversed the growth of squamous cell vulvar cancers in some women with the disease.

The differential diagnosis for vulvar squamous cell carcinoma (VSCC) includes several conditions that can mimic or be confused with VSCC. Some of these conditions are:

• Vulvar intraepithelial neoplasia (VIN): This is a precancerous condition that can progress to VSCC if left untreated [10][11].
• Human papillomavirus (HPV)-associated lesions: Certain types of HPV can cause changes in the vulvar skin that may be mistaken for VSCC [5][12].
• Seborrheic keratosis: This is a benign growth that can appear on the vulva and may be confused with VSCC [6][9].
• Viral warts: These are caused by HPV and can appear on the vulva, potentially leading to confusion with VSCC [6][9].
• Paget disease: A rare condition that can cause changes in the skin of the vulva, which may be mistaken for VSCC [11].
• Amelanotic melanoma: A type of skin cancer that can appear on the vulva and may be confused with VSCC [11].

It's essential to note that a proper diagnosis of VSCC requires a thorough examination by a healthcare professional, including a biopsy and histopathological examination.

References:

[5] I Alkatout · 2015 · Cited by 294 — Vulvar cancer can be distinguished into two separate diseases: the first type involves a human papillomavirus (HPV) infection that causes vulvar intraepithelial ...

[6] What is the differential diagnosis of vulval cancer? · Viral wart, seborrheic keratosis · Vulval cyst or abscess · Inflammatory dermatoses including flexural ...

[9] Apr 8, 2019 — Differentiating vulvar cancer from other Diseases · Menometorrhagia · Intermenstrual bleeding · Postcoital bleeding · Polyuria · Dysuria · Fatigue ...

[10] Outcome of HPV associated vulvar squamous cell carcinoma (VSCC) is favorable compared to HPV independent VSCC (Int J Cancer 2018;142:1158, Histopathology 2017;71:238)

[11] Vulvar squamous cell carcinoma is an invasive epithelial tumor composed of squamous cells, which can arise by human papillomavirus (HPV)-associated (“usual type”) or HPV-independent (“simplex type”) pathways. ... The main entities in the differential diagnosis for invasive squamous cell carcinoma are vulvar intraepithelial neoplasia ...

[12] Vulvar squamous cell carcinoma (VSCC), accounting for 85 to 90% of cases of vulvar cancer, 6 is the most common type of malignant vulvar tumor, followed by melanoma ... Differential diagnosis includes VIN precursors, anogenital warts, seborrheic keratoses, psoriasis, Paget disease, amelanotic melanoma, chancroid, Crohn disease, and metastatic ...