It is most commonly squamous cell carcinoma in type, although other histologic types do occur. In many cases, the development of vulvar cancer is preceded by condyloma or squamous dysplasias. The clitoris and Bartholin's glands are less frequently involved. Well-differentiated lesions tend to spread along the surface with minimal invasion, while anaplastic lesions are more likely to be deeply invasive. Spread beyond the vulva is either to adjacent organs such as the vagina, urethra, and anus, or via the lymphatics to the inguinal and femoral lymph nodes followed by the deep pelvic nodes.
Hematogenous spread appears to be uncommon.
Homesley HD, Bundy BN, Sedlis A, et al. Boyce J, Fruchter RG, Kasambilides E, et al. Risk factors for the development of lymph node metastasis in vulvar squamous cell carcinoma. Homesley HD, Bundy BN, Sedlis A, et al. Macnab JC, Walkinshaw SA, Cordiner JW, et al.