Vulvar carcinoma, also known as vulvar cancer, is a rare malignant tumor disease of the external genital organs in women. The term vulvar carcinoma is derived from the Latin word "vulva" - meaning "female vulva" - and the Greek word "karkínos" - meaning "cancer". Here you will find further information and selected vulvar cancer specialists and centers.
In principle, malignant vulvar tumors can occur in all regions of the female pubic area. In most cases, however, vulvar cancer affects the labia majora (outer labia) and, more rarely, the labia minora (inner labia). Overall, around 80 percent of all vulvar cancers occur in the labia majora and labia minora. The clitoris is only affected in around 10 percent of cases.
Depending on the cells from which a malignant tumor of the vulva originates, different forms of vulvar cancer can be distinguished.
Around 90 percent of all malignant vulvar tumors are so-called squamous cell carcinomas. These tumors are of epithelial origin, i.e. they develop from cell changes in the uppermost layer of the skin. They are considered vulvar carcinomas in the true sense of the word.
Vulvar cancer can also develop from other cell types. For example, the remaining 10 percent of vulvar cancer cases include
Vulvar carcinoma accounts for around 4 to 5 percent of all tumor diseases of the female genital tract. This makes it the fourth most common cancer of the female genital organs.
Overall, around two in every 100,000 women in Germany are diagnosed with vulvar cancer every year. This corresponds to around 1,600 new cases per year.
The majority of those affected are older women aged 70 and over. In recent years, however, the incidence rate has also increased among younger women.
The term vulva covers the external, primary sexual organs of women. These include
The labia majora, also known as the labia majora pudendi, together with the mons pubis, form the outer boundary of the vulva. They consist of two large skin bulges that surround the pubic cleft and join in front of the clitoris and anus.
The labia minora, also known as the labia minora pudendi, are two thin, wrinkled folds of skin. They are located between the labia majora in the pubic cleft. The clitoris is located on the anterior fold.
The vaginal vestibule is surrounded by the labia minora and opens into the urethra, the vagina and some glandular ducts.
The exact causes and correlations for the development of vulvar cancer are not yet fully known. However, some risk factors can promote the development of a malignant tumor of the vulva.
These include, in particular, an infection with the so-called human papilloma virus (HPV), which is transmitted during sexual intercourse.
It is also being discussed that infections with othersexually transmitted pathogens such as
could be associated with an increased risk of vulvar cancer.
Other risk factors are
In the early stages, vulvar cancer usually causes little or no symptoms.
Early symptoms include small white or reddish, slightly raised spots or indurations in the genital area that resemble warts or scars.
In the advanced stages of vulvar cancer, symptoms typically include
occur.
In addition, at an advanced stage there is often
Various tumor stages are distinguished in vulvar carcinoma according to the so-called FIGO classification. They are defined by the Fédération Internationale de Gynécologie et d'Obstétrique (French for: International Federation of Gynecology and Obstetrics).
The FIGO classification for vulvar cancer is as follows
The suspected diagnosis of vulvar cancer is usually made during a medical history interview and a gynecological examination.
During the anamnesis interview, the doctor first asks the patient about her medical history and complaints.
During the gynecological examination, the doctor will palpate the genital area. He also examines the vulva for any noticeable color and/or surface changes to the mucous membrane. For this purpose, he often uses a so-called colposcope, with which he can view the mucous membrane in multiple magnification.
The diagnosis is made as part of a gynecological examination © Mariakray | AdobeStock
In suspected cases, he takes a tissue sample (biopsy), which he then has examined histologically in the laboratory. If malignant cancer cells are detected under the microscope, the diagnosis of "vulvar carcinoma" is confirmed.
In the next step, the doctor uses various imaging techniques to determine how far the tumor has already spread. These include in particular
Vulvar cancer is treated by gynecologists specializing in gynecological oncology. They have various treatment options available for the treatment of vulvar cancer, including surgery, radiotherapy and chemotherapy.
Which form of therapy is used depends on the stage of the tumor.
During surgery, the vulvar carcinoma must be completely removed. In the case of vulvar carcinomas in the early stages, it is usually sufficient to generously excise the affected area of skin.
If the disease is already at an advanced stage, it may be necessary to remove the entire vulva and possibly also all or part of the vagina and/or urethra.
The question of lymph node involvement can often be clarified by means of a sentinel lymph node biopsy. Sometimes the lymph nodes in the groin must also be removed, both superficially and deeply. This may also involve the lymph nodes of the pelvis.
In advanced cases, radiotherapy in combination with chemotherapy is necessary in addition to surgical treatment.
To prevent vulvar cancer, it is advisable to have a check-up with your gynecologist at least once a year. Pre-cancerous stages of vulvar cancer can be detected and treated in good time.
An HPV vaccination has also been available for some time. It protects against infection with human papillomavirus types 16 and 18, two virus types that are considered risk factors for cervical cancer and vulvar cancer.
The vaccination is primarily recommended for girls aged 12 to 17.
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