467
Vulvar and Vaginal
Carcinoma
Chapter 48
Lauren Abern, MD and
Mitchell I. Edelson, MD❍ What percentage of gynecologic malignancies originate on the vulva?
3% to 5%.
❍ What is the average delay in diagnosis of vulvar cancer?
12 months (6 months patient delay, 6 month physician delay).
❍ What are the borders of the superficial inguinal nodes?
Inguinal ligament superior.
Border of sartorius muscle laterally.
Border of adductor longus medially.
❍ What is the name of the fascia that is located above the deep inguinal nodes?
The cribriform fascia that makes up the covering of the femoral sheath.
❍ Observational association of what risk factors have been linked with vulvar cancer?
(1) Advancing postmenopausal age.
(2) Hypertension.
(3) Diabetes.
(4) Obesity.
(5) Smoking.
❍ What link does the human papilloma virus (HPV) have, if any, with vulvar cancer?
HPV DNA can be identified in about 70% to 80% of intraepithelial lesions, but is seen in only 10% to 50% of
invasive lesions. HPV type 16 seems to be most common, but types 6 and 33 have also been identified.
❍ True or False: Lichen sclerosis has been proven to be a precursor of and leads to invasive vulvar cancer.
False.