Vulvar tumors typically look like any of the following, including a cauliflower-like wart, red or pink bump, or lightened or darkened skin.
A vulvar tumor can look like anything that includes:
- Simple wart
- Cauliflower-like wart
- White, pink, or a red-colored rough or thick lump or bump
- Thickened skin
- Lightened or darkened skin
- Persisting open sore (lasts for more than one month)
- An itchy area that appears rubbery to touch
The most common symptom associated with vulvar tumors includes itching that does not go away.
Some women may experience additional symptoms such as:
- Burning or pain in the vulva region
- Pain during intercourse
- Vaginal bleeding in between two menstrual periods
- Postmenopausal bleeding
3 types of vulvar tumors
The 3 types of vulvar tumors include:
- Squamous cell carcinoma: It is the most common type of vulvar tumor and begins in your skin cells. The majority of this type of tumor is found in women with human papillomavirus infection, especially younger women. Its subtype, verrucous carcinoma, looks like a wart.
- Adenocarcinoma: It resembles a cyst and usually begins in the Bartholin’s glands, which are located just inside the opening of your vagina. If it begins in the Bartholin’s glands, it is called Bartholin gland cancer. If it forms in the sweat glands or the top layer of the vulvar skin, it is called Paget’s disease.
- Melanoma: It develops from the pigment-forming cells of the vulva.
Other less common types of vulvar tumor include:
- Sarcoma: Can occur at any age, including childhood
- Basal cell carcinoma: The most common type of skin cancer but very rare on the skin of the vulva
What causes vulvar tumors?
- One of the two causes of squamous cell cancer of the vulva is mutations in a type of gene known as p53 tumor suppressor gene. This gene plays an important role in preventing the cells from turning cancerous.
- When mutations develop in this gene, cancer cells undergo uncontrolled division that causes the vulvar tumor to develop.
- The tumor developed in this way does not involve HPV infection and is usually diagnosed in women older than 55 years.
Nothing concrete is known about how vulvar melanomas and adenocarcinomas because these types of vulvar tumors are rare.
How is a vulvar tumor diagnosed?
A vulvar tumor is easy to be missed because many of its symptoms are found in other illnesses that are not cancer. Your doctor will ask you to describe your symptoms, following which they will take your medical history.
Next, they will perform examinations and tests that include:
- Pelvic examination: Your doctor will examine your vulva to look for any signs such as warts, bumps, lumps, or any discoloration.
- Colposcopy: Your doctor may like to closely examine the vulva, vagina, and cervix by using a special tool known as a colposcope that helps them visualize these structures more clearly.
- Biopsy: Your doctor might remove a small piece of tissue from your vulva and send it to the laboratory for examination under a microscope. The test lets your doctor know whether the piece contains normal or cancer cells.
- Imaging tests: If your doctor wants to know if you have cancer in any other part of the body, they may order imaging tests such as ultrasound, X-ray, computed tomography, or magnetic resonance imaging scan.
The vagina includes the labia, clitoris, and uterus.
How is a vulvar tumor treated?
The most commonly used treatment of vulvar tumors is surgery.
Depending on the extent of the vulvar tumor, your doctor may perform any of the two following surgeries:
- Wide local excision (or radical excision): Your doctor will remove the tumor and part of adjacent healthy tissue that is likely to become cancerous.
- Vulvectomy: Removing the tumor along with a greater part of the vulva is known as partial vulvectomy. Removing the entire vulva is known as radical vulvectomy.
In addition to the above surgeries, your doctor may remove the lymph nodes that are likely to be cancerous. A small piece of the lymph nodes is then sent to the laboratory to check if vulvar cancer has spread to the lymph nodes.
Radiation therapy and chemotherapy
Radiation therapy uses high-energy waves that are focused on the vulvar tumor. It may be done before the surgery to shrink the tumor and make the surgery easier to be performed.
Chemotherapy uses strong medications to kill cancer cells. This therapy is most often reserved for people whose cancer has reached an advanced stage and spread to other organs of the body. It may be given alone or in combination with radiation therapy before the surgery to shrink the tumor.
Targeted drug therapy
Targeted drug treatments are not as commonly used as surgery, radiation therapy, and chemotherapy. These are used as an option for advanced vulvar cancer. The therapy involves using medications that focus on specific abnormalities present within cancer cells, thereby causing cancer cells to die.
Immunotherapy is reserved for certain cases of advanced vulvar cancer. It involves giving medications intravenously that use your immune system to fight against the cancer cells.