Squamous cell carcinoma of the vulva (VSCC) is a rare cancer. Some are associated with HPV-related precursor lesions (vulval intraepithelial neoplasia usual type) especially those associated with HPV 16 (99). However, most cancers are not related to HPV infection. For instance, lichen sclerosus is a non-HPV related skin condition with an increased risk of development of vulval neoplasia-differentiated VIN (dVIN) (100). Other chronic inflammatory dermatoses may also be associated with dVIN which is more likely to occur in older post-menopausal women (101). There is an increased risk of vulvar cancer if there has been previous cervical or vaginal cancer. Tumor size and P53 positivity are linked to a poorer prognosis and increased mortality compared to HPV p16 positive cancers (102).
There are no recommendations regarding screening for vulval cancer.
Women may present with either as a lump or ulcer, itching or soreness or as a skin lesion such as a mole. Some women may present with enlarged inguinal lymph nodes.
Diagnosis is made by biopsy with histopathological examination of tissue.
The treatment depends on the stage of the disease and may involve surgery alone or with chemoradiotherapy.