Vulvar cancer: Diagnosis and treatment [Vulvakarzinom: Diagnostik und therapie]

Vulvar cancer is a rare entity. It appears mostly in older women aged 70-79 years with a slow tendency toward younger age. More than 90% of the tumors show a squamous differentiation. The correspondent preneoplasia is VIN. This lesion occurs in women mostly younger than 35 years. Experts assume that vulvar cancer appears in two different types: HPV-induced type in younger women and non-HPV-dependent type in older women. The preneoplasia VIN already should be treated by resection or destruction. Invasive carcinomas stage I or II can be treated by wide local excision. The inguinofemoral lymph nodes should be resected if invasion exceeds 1 mm in depth. In larger primary tumors, vulvectomy with bilateral inguinofemoral node dissection is indicated. In advanced tumor stages, multimodal concepts are applied: primary radiochemotherapy may precede a salvage operation. © 2008 Springer Medizin Verlag.