TAILIEUCHUNG - Ebook Principles and practice of gynecologic oncology: Part 2
(BQ) Part 2 book “Principles and practice of gynecologic oncology” has contents: Vaginal cancer, cervix uteri, epithelial ovarian cancer, ovarian germ cell tumors, ovarian sex cord – stromal tumors, breast cancer, palliative and supportive care, and other contents. | SECTION III D ISEASE S ITES 832 CHAPTER 18 Vulva Emily Penick, Sushil Beriwal, Edward J. Wilkinson and John W. Moroney* INTRODUCTION Malignant tumors of the vulva are rare and account for less than 5% of all cancers of the female genital tract. In 2015, there were an estimated 5,150 new cases of and 1,080 deaths from invasive vulvar carcinoma in the United States (1). Because of its low incidence, most primary care providers will never encounter a patient with vulvar cancer. Although a rare patient with vulvar cancer will present without symptoms, most women with vulvar cancer initially present with complaints such as vulvar irritation, pruritus, pain, or a mass that does not resolve. The interval between the onset of symptoms and the diagnosis of cancer can be protracted if a woman who is embarrassed by new vulvar symptoms delays seeking care, or if a physician prescribes empiric topical therapies without a proper physical examination or tissue biopsy confirmation. Jones and Joura (2) evaluated the clinical events preceding the diagnosis of squamous cell carcinoma of the vulva and found that 88% of patients had experienced symptoms for more than 6 months, 31% of women had three or more medical consultations before the diagnosis of vulvar carcinoma, and 27% had applied topical estrogen or corticosteroids to the vulva. The vulva is covered by keratinized squamous epithelium; accordingly, most malignant vulvar tumors are squamous cell carcinomas (SCCs). Consequently, our current understanding of the epidemiology, spread patterns, prognostic factors, and survival data for vulvar cancer is largely derived from experience with SCCs. Malignant melanoma is the second most common cancer of the vulva. Although there is some consensus regarding the behavior and treatment of vulvar melanoma, its rarity has thus far precluded robust, prospective clinical trials. A number of other malignant tumors, both epithelial and stromal in origin, arise from normal vulvar tissue and .
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