A woman is found to have a unilateral invasive carcinoma of vulva that is 1 cm in diameter with no stromal invasion and is not associated with evidence of lymph node spread. Initial management should consists of :
The patient in question appears to have vulval cancer with stage 1A with unifocal lateral lesion VULVAL CARCINOMA: STAGING AND MANAGEMENT STAGE 1 1A Limited to vulva/perineum Size<=2cm stromal invasion <=1mm Wide local excision + sentinel lymph node study 1B Size >2cm stromal invasion >1mm Radical local excision plus * B/L LAD: central lesion * U/L LAD: lateral lesion (>2cm from midline) STAGE 2 Any size ,Spreads to lower 1/3 urethra, lower 1/3 vagina, anus Early: radical excision/ radical vulvectomy plus B/L LAD Advanced: radiation + surgery + LAD STAGE 3 Positive inguinofemoral lymph nodes Radiation + surgery + LAD STAGE 4A 4B Upper urethra, upper vagina, bladder, rectum, pelvis side wall Distant metastasis, Pelvic or other lymph nodes Radiation + surgery + LAD LAD= lymphadenectomy Radical local excision: excision of entire tumour with at least 1 cm grossly negative margin and extended down to inferior fascia of urogenital diaphragm. Senrinel lymph nodes studies: reliable and suitable in early stage disease with unifocal lesion less than 4 cm and clinically negative lymph nodes on groin examination and imaging.
Chemotherapy
Radiation therapy
Wide excision and Sentinel lymph node biopsy
Radical vulvectomy and bilateral inguinal lymphadenectomy
Ovarian Tumors and Vulvar cancer