{"id":2610,"date":"2020-08-13T16:14:21","date_gmt":"2020-08-13T16:14:21","guid":{"rendered":"https:\/\/brooksidepress.org\/basic_obgyn\/?page_id=197"},"modified":"2021-05-09T20:52:52","modified_gmt":"2021-05-09T20:52:52","slug":"51-vulvar-neoplasms","status":"publish","type":"page","link":"https:\/\/brooksidepress.org\/pa_obgyn\/overview\/51-vulvar-neoplasms\/","title":{"rendered":"51. Vulvar Neoplasms"},"content":{"rendered":"<p><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/70k4LoOusFI\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>Duration = 4:59<\/p>\n<input type='hidden' bg_collapse_expand='69e9b59d0817b4030150270' value='69e9b59d0817b4030150270'><input type='hidden' id='bg-show-more-text-69e9b59d0817b4030150270' value='Show Transcript'><input type='hidden' id='bg-show-less-text-69e9b59d0817b4030150270' value='Hide Transcript'><button id='bg-showmore-action-69e9b59d0817b4030150270' class='bg-showmore-plg-button bg-blue-button  '   style=\" color:#ffffff;\">Show Transcript<\/button><div id='bg-showmore-hidden-69e9b59d0817b4030150270' ><\/p>\n<p>00:00<br \/>\nAPGO educational topic number 51<br \/>\n00:02<br \/>\nvolver neoplasms all of our carcinoma<br \/>\n00:05<br \/>\naccounts for 5% of all gynecologic<br \/>\n00:07<br \/>\nmalignancies and is the fourth most<br \/>\n00:08<br \/>\ncommon gynecologic cancer the symptoms<br \/>\n00:11<br \/>\ncan be vague and sensitive for patients<br \/>\n00:13<br \/>\nto talk about early recognition and<br \/>\n00:16<br \/>\nproper evaluation of vulvar neoplasms<br \/>\n00:18<br \/>\ncan reduce morbidity and mortality the<br \/>\n00:20<br \/>\nobjectives of this video are to list<br \/>\n00:21<br \/>\nrisk factors for vulvar neoplasms<br \/>\n00:23<br \/>\ndescribe the symptoms and physical exam<br \/>\n00:26<br \/>\nfindings of a patient with a volver<br \/>\n00:27<br \/>\nneoplasm and lastly list the indication<br \/>\n00:30<br \/>\nfor vulvar biopsy here is our patient<br \/>\n00:32<br \/>\nthis paretic vulva the main age of<br \/>\n00:35<br \/>\ndiagnosis is 65 20 percent of patients<br \/>\n00:38<br \/>\nwith vulvar cancers however I diagnosed<br \/>\n00:40<br \/>\nat an age less than 50 they are thought<br \/>\n00:42<br \/>\nto be two independent pathways for valve<br \/>\n00:44<br \/>\nour Christina Genesis the first is<br \/>\n00:46<br \/>\nrelated to HPV infection and the second<br \/>\n00:49<br \/>\nis related to chronic inflammatory<br \/>\n00:50<br \/>\nprocesses risk factors thus include<br \/>\n00:53<br \/>\ncigarette smoking prior history of<br \/>\n00:55<br \/>\ncervical cancer vulva or cervical<br \/>\n00:57<br \/>\nintraepithelial neoplasia lykan<br \/>\n00:59<br \/>\nsclerosis and northern European ancestry<br \/>\n01:01<br \/>\nvolver itching is the most common<br \/>\n01:03<br \/>\npresenting complaint patients might<br \/>\n01:05<br \/>\nnotice a red or white ulcerative or EXO<br \/>\n01:07<br \/>\nFinnick lesion on the posterior<br \/>\n01:09<br \/>\ntwo-thirds of either labia of Ages here<br \/>\n01:12<br \/>\nis a photograph of an exofit ik<br \/>\n01:14<br \/>\nulcerative lesion<br \/>\n01:15<br \/>\nyou may remember dr. vulva vagina from<br \/>\n01:18<br \/>\nhits such as apka video number 35 vulvar<br \/>\n01:21<br \/>\nand vaginal diseases doctor vulva vagina<br \/>\n01:23<br \/>\nis comfortable asking her patients about<br \/>\n01:25<br \/>\nvulvar and vaginal symptoms remember<br \/>\n01:28<br \/>\nthat many of our patients will be<br \/>\n01:29<br \/>\nreluctant to speak with their physician<br \/>\n01:31<br \/>\nabout symptoms down there and<br \/>\n01:32<br \/>\nunfortunately many of our patients are<br \/>\n01:34<br \/>\nnot familiar with their female anatomy<br \/>\n01:36<br \/>\nit is very important as a woman&#8217;s health<br \/>\n01:38<br \/>\ncare provider to feel comfortable asking<br \/>\n01:40<br \/>\nwomen about their symptoms to perform an<br \/>\n01:42<br \/>\nexam if she has symptoms and at this<br \/>\n01:44<br \/>\npoint let&#8217;s briefly review vulva anatomy<br \/>\n01:46<br \/>\nthis is our patient and lithotomy the<br \/>\n01:48<br \/>\nvulva contains the labia majora labia<br \/>\n01:50<br \/>\nminora Mons pubis clitoris vestibule and<br \/>\n01:53<br \/>\nducts of glands that opened into the<br \/>\n01:55<br \/>\nvestibule here are the labia majora the<br \/>\n01:57<br \/>\nlabia majora are the folds of skin that<br \/>\n01:59<br \/>\ncontain hair follicles as well as<br \/>\n02:04<br \/>\nsebaceous and sweat glands<br \/>\n02:07<br \/>\nthe labia minora are the folds of skin<br \/>\n02:09<br \/>\nwithin the labia majora the labia minora<br \/>\n02:16<br \/>\nmerge anteriorly with the prepuce and<br \/>\n02:19<br \/>\nfen ulam of the clitoris and posterior<br \/>\n02:21<br \/>\nLee with the labia majora and the<br \/>\n02:23<br \/>\nperineum the labia minora have no hair<br \/>\n02:25<br \/>\nfollicles but do you have sebaceous and<br \/>\n02:27<br \/>\nsweat glands the vestibule is the area<br \/>\n02:30<br \/>\nbetween the labia minora and contain the<br \/>\n02:33<br \/>\nurethral meatus and the opening of the<br \/>\n02:38<br \/>\nvagina which is called the vaginal<br \/>\n02:39<br \/>\nintroitus the peri urethral glands are<br \/>\n02:44<br \/>\nscheme&#8217;s ducts have an opening here and<br \/>\n02:46<br \/>\nthe Barth Ilan&#8217;s gland empties into the<br \/>\n02:50<br \/>\nvestibule they&#8217;re approximately 90% of<br \/>\n02:54<br \/>\nvulvar cancers are squamous cell<br \/>\n02:56<br \/>\ncarcinomas these generally remain<br \/>\n02:58<br \/>\nlocalized for long periods of time and<br \/>\n03:00<br \/>\nthen spread in a predictable fashion to<br \/>\n03:02<br \/>\nthe regional lymph nodes melanoma is the<br \/>\n03:04<br \/>\nmost common non squamous cell carcinoma<br \/>\n03:06<br \/>\nthe vulva and account for five to ten<br \/>\n03:08<br \/>\npercent of primary vulvar neoplasms<br \/>\n03:10<br \/>\nmelanoma is most commonly located on the<br \/>\n03:13<br \/>\nlabia minora or the clitoris it usually<br \/>\n03:15<br \/>\npresents with a raised irritated paretic<br \/>\n03:17<br \/>\nand pigmented lesion if diagnosed early<br \/>\n03:19<br \/>\nwhen confined to the intra papillary<br \/>\n03:21<br \/>\nRidge survival approaches 100% if the<br \/>\n03:24<br \/>\nmelanoma has invaded into the<br \/>\n03:26<br \/>\nsubcutaneous tissue survival is<br \/>\n03:28<br \/>\ngenerally approximately 20% by finland<br \/>\n03:31<br \/>\ngland carcinoma accounts for one to two<br \/>\n03:33<br \/>\npercent of vulvar cancers the birth lung<br \/>\n03:35<br \/>\nglands have ducts that open into the<br \/>\n03:37<br \/>\nvestibule at the four and eight o&#8217;clock<br \/>\n03:42<br \/>\nposition on each side of the vaginal<br \/>\n03:45<br \/>\norifice Barthel and gland carcinomas<br \/>\n03:49<br \/>\ngenerally occur in women over age 60<br \/>\n03:51<br \/>\nhowever any birth leg landmass and woman<br \/>\n03:53<br \/>\nover age 40 should be biopsied let&#8217;s go<br \/>\n03:57<br \/>\nback to doctor vulva vagina she is<br \/>\n03:58<br \/>\ncomfortable asking patients about vulvar<br \/>\n04:00<br \/>\nsymptoms and performs an exam of the<br \/>\n04:02<br \/>\nvulva region when patients are<br \/>\n04:03<br \/>\nsymptomatic she knows your vulva anatomy<br \/>\n04:06<br \/>\nand she&#8217;ll have a low threshold for<br \/>\n04:07<br \/>\nperforming a vulva biopsy indications<br \/>\n04:10<br \/>\nfor vulva biopsy include lesions that<br \/>\n04:12<br \/>\nare clinically suspicious for malignancy<br \/>\n04:14<br \/>\nthey have asymmetry<br \/>\n04:15<br \/>\nborder irregularity color variation<br \/>\n04:18<br \/>\nbleeding or a non-healing ulcer<br \/>\n04:20<br \/>\nif the diagnosis cannot be made<br \/>\n04:22<br \/>\nconfidently if the lesion does not<br \/>\n04:25<br \/>\nresolve after standard therapy and<br \/>\n04:26<br \/>\nlastly to address patient concerns this<br \/>\n04:30<br \/>\nconcludes the aapko video on vulvar<br \/>\n04:32<br \/>\nneoplasms we have discussed how the risk<br \/>\n04:34<br \/>\nfactors relate to both HPV infection and<br \/>\n04:36<br \/>\nchronic inflammatory processes and<br \/>\n04:38<br \/>\nreviewed the symptoms and physical<br \/>\n04:39<br \/>\nanatomy findings as well as the<br \/>\n04:41<br \/>\nimportance for having a low threshold<br \/>\n04:42<br \/>\nfor vulvar biopsy<\/p>\n<p><\/div>\n<hr \/>\n","protected":false},"excerpt":{"rendered":"<p>Duration = 4:59<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":46,"menu_order":51,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-2610","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages\/2610","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/comments?post=2610"}],"version-history":[{"count":1,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages\/2610\/revisions"}],"predecessor-version":[{"id":2857,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages\/2610\/revisions\/2857"}],"up":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages\/46"}],"wp:attachment":[{"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/media?parent=2610"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}