Cancerous Lesions of the Vulva

The vulva, which is the external part of the female genitalia, although it has numerous functions, is relatively rarely the focus of attention regarding neoplastic changes. Such changes can manifest in both benign and malignant forms. While benign tumors, such as lipomas or fibromas, generally do not pose serious health risks, their removal may be necessary for accurate diagnosis. This procedure requires microscopic examination to confirm that the lesion is indeed benign.

Vulvar malignancies, although less common, are still concerning, as they account for about 5% of tumors affecting the female genital organs. The most common type is squamous cell carcinoma, which arises from the histological structure of the vulva. Additionally, there are other forms such as adenocarcinoma or Bartholin’s gland cancer. Early detection of the disease is crucial for recovery, making it important for women to be aware of the warning signs.

Types and Incidence of Vulvar Neoplastic Changes

Vulvar neoplasms vary significantly from one another, both in terms of histological type and appearance. Benign lesions, such as fibromas and lipomas, while common, generally do not cause serious issues; however, their removal may be essential for confirming the diagnosis. In the case of malignant tumors, squamous cell carcinoma is the most prevalent, accounting for approximately 90% of vulvar tumors.

Tumors primarily occur in older women, but in recent years, an increasing number of cases in younger women have been registered. Research indicates that several factors may play a role in the development of neoplastic changes. Women who smoke, are obese, or have diabetes may be more susceptible to these issues. Furthermore, an increase in the number of sexual partners, a lack of childbirth, and human papillomavirus (HPV) infections can also elevate the risk.

Squamous cell carcinoma of the vulva most commonly originates from the labia majora but can also appear on the labia minora, the area of the clitoris, or the skin of the perineum. As the tumor progresses, it may spread to other areas, such as the vagina, rectum, or urethra. Early-stage metastases can develop in the inguinal and pelvic lymph nodes, and later may appear in the lungs, bones, and liver.

Symptoms and Diagnosis of Vulvar Squamous Cell Carcinoma

The symptoms of vulvar squamous cell carcinoma can manifest in various ways, and the lesions may initially go unnoticed. The most common warning signs include ulcers on the vulva, raised lesions, or wart-like growths. If these are accompanied by itching, bleeding, or discharge, it may indicate a more serious problem. Swelling of the inguinal lymph nodes can also support the suspicion of vulvar cancer.

During diagnosis, a tissue sample is taken from the lesion, which is then subjected to microscopic examination. Additionally, various imaging procedures, such as chest X-rays, abdominal ultrasounds, CT scans, and MRIs, are necessary to accurately determine the tumor’s location and extent.

Treatment of Vulvar Tumors

The treatment of vulvar tumors largely depends on the type and stage of the tumor. The primary form of treatment is the surgical removal of the tumor. In young patients with small tumors that have not invaded deeply, surgeons may sometimes employ local excision, thereby avoiding radical surgical solutions that could cause significant psychological distress.

In more severe cases, complete removal of the vulva may be necessary, which includes the excision of the labia majora, labia minora, clitoris, and adipose tissue. This procedure is typically performed alongside the excision of nearby lymph nodes. If cancer is found in the lymph nodes, further treatments, such as chemotherapy, may be required depending on the severity of the disease.

Another type of cancer that can affect the vulva is malignant melanoma. This skin cancer can also originate from the surface of the vulva, and its diagnosis and treatment are similar to that of squamous cell carcinoma. Basal cell carcinoma, although rare, can also occur and is generally less aggressive than the previous types. Tumors of Bartholin’s gland can also pose a problem, as they are often diagnosed late.

Importance of Screening and Prevention

To prevent and detect vulvar tumors early, it is essential for women to participate in regular gynecological examinations. Any changes, lumps, or unusual symptoms should prompt immediate medical consultation. Early diagnosis is crucial, as the sooner a neoplastic disease is detected, the greater the chance for successful treatment and less invasive intervention.

Proper education and regular medical check-ups can help reduce the risk of vulvar tumors. Maintaining a healthy lifestyle, avoiding smoking, and preserving sexual health can also help prevent the onset of diseases.