Squamous carcinomas usually appear as vulvar masses of irregular and polypoid shape. Sometimes leukoplakia is present, and these lesions can be white, red, or pigmented. Vulvar cancer may appear as benign diseases such as nevi, dermatoses, or nonneoplastic conditions like squamous hyperplasia. Later-stage or advanced disease can produce a large, exophytic vulvar mass, but less advanced disease may arise as a smaller lesion. Any health care provider evaluating a vulvar lesion in a patient with a history of a non-healing sore or chronic pruritis should strongly consider biopsy, with colpgscony if necessary, or referral for biopsy.
Prognosis depends on the lesion size and extent of spread.
Treatment depends on the extent of disease and anatomic location. Some lateral tumors are treated with radical wide excision, and possible ipsilateral inguinal-femoral lymphadenectomy. More extensive disease may require bilateral lymphadenectomy, and some cases require a modified radical vulvectomy, a disfiguring procedure. Thus, prevention of this disease by treating VIN, or diagnosis at an early stage, may allow the gynecologic-oncologist to treat this disease by less radical methods. Melanoma typically appear like melanoma in other areas.