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- A 60-year-old woman is referred to the rapid access 2 week wait clinic with vulval itching and soreness. Vulval examination reveals small ivory-coloured slightly raised areas which join to form white patches in a figure-of-eight distribution. Vaginal introitus is narrowed with atrophy of the labia minora. Vulval mapping biopsies reveal lichen sclerosus. Her associated risks include all of the following except which one condition?
- A 40-year-old woman presents with severe vulval pruritus. Vulvoscopy reveals acetowhite areas following application of acetic acid. Vulval mapping biopsy reveals usual type (human papilloma virus [HPV] related) of VIN. She can be treated with which one of the following methods?
- A 70-year-old woman is referred to rapid access clinic. Her main symptom is vulval itching and soreness. Vulval examination reveals erythematous vulva with excoriation and lichenification. Vulval biopsy shows large pleomorphic cells with amphophilic, granular cytoplasm and prominent nucleus and mainly located in the lower portion of the epidermis. Occasional signet cells were seen. The cells stained positive with mucicarmine and PAS. Immunohistochemical studies showed positivity with EMA, CAM 5.2, CK7 and GCDFP-15. The doctor recommends vulval excision. What is the most likely diagnosis in her case?
- Which of the following vulval skin disorders is associated with the highest risk of developing malignant disease?
- Which of the following is a premalignant condition?
- The recommended first line of treatment in Lichen sclerosus is:
7. A 65-year-old woman complaining of severe itching is diagnosed with Vulval intraepithelial neoplasia (VIN) 3 on biopsy. What is the first line of management?CorrectIncorrect
8 A 65-year-old woman presents with a history of vulval discomfort and soreness for 6 months. On examination, there is 2.5 cm raised ulcerated area on the left labia majora which looks highly suspicious of vulval cancer. What is the first line of investigation?CorrectIncorrect
9. Vulval cancers account for 6% of gynaecological cancers in the United Kingdom. In 2009, a new FIGO staging was introduced with greater emphasis on the inguino-femoral lymph node status to understand prognosis. What is the FIGO stage for a woman who has a 3cm vulval cancer involving the anus with metastases in 2 lymph nodesCorrectIncorrect
- Recently, the prevalence of HPV-related VIN has increased significantly and consequently the incidence of vulval cancer in young women is rising. What are the most common HPV serotypes found in vulval cancers?