A STUDY OF MALIGNANT LESIONS OF VULVA

Abstract

INTRODUCTION: Vulvar cancer is uncommon and relatively rare. Vulvar cancers do not always go through the preinvasive stages before developing into invasive cancer. It represents 1-4% of malignancies of female genital tract. Most common among the valvar cancer is squamous cell carcinoma (90%). Less common is melanoma, basal cell carcinoma, Adenocarcinoma and sarcoma which account for 10%. AIM: To determine the prevalence among genital tract malignancies, histopathological pattern, Staging, modality of treatment and post operative complications of malignant lesion of vulva. METHODS: It is a Cross sectional study carried out in Madurai medical college. The medical records of all women with malignant lesion of vulve between January 2009 to September 2011 were reviewed. From the case record, the patient profile, complaints, associated medical complications were noted. The record of investigations, treatment modalities and postoperative complications were studied. The diagnosis was confirmed by biopsy and clinical staging was done and planned for treatment. RESULTS: 10 cases of malignant lesions of vulva were noted during the period. Prevalence is about 0.8% of all genital tract malignancies. Age wise distribution reveals 60 % of our cases were above 60 years of age. 80% of our prevalence observed in postmenopausal women. Most patient had complaints of pruritis (100%), ulcer(70%), swelling(30%). Had associated medical complication of diabetic (40%), hypertensive (20%). Histopathologically the most predominant type is squamous cell carcinoma (60%), malignant melanoma (10%), basal cell carcinoma(10%), Baseloid squamous cell carcinoma(10%), Vulvar intraepithelial neoplasia (10%). Stage wise classification of squamous cell carcinoma –stage 0-12.5%, stage2- 37.5%, stage 3- 37.5%, stage 4 – 12.5%. CONCLUSION: Most cases above 60 yrs of age and 80% of our cases shows squamous cell carcinoma. Prevalence is about 0.8% of all genital tract malignancies. Most of the cases reported in the advanced stage of vulvar cancer. Biopsy is the method to confirm the diagnosis, Early diagnosis has a good prognosis . five year survival in stage 1 is 90%.