PERIMENOPAUSAL BLEEDING IN A REPRODUCTIVE AGE WOMEN IS A COMOUFLAGE FOR A HIDDEN VULVAL CARCINOMA

Abstract

Vulval cancer is a relatively rare gynecologic malignancy, predominantly affecting postmenopausal women. Currently, there aren’t any established population-based screening protocols for its early detection. As such, the most effective strategy for reducing its incidence remains the timely identification and treatment of predisposing conditions and preneoplastic lesions, such as vulval intraepithelial neoplasia (VIN), that are associated with its pathogenesis. Although vulval cancer may be asymptomatic in its early stages, the majority of patients present with symptoms such as pruritus, pain, or the detection of a vulvar mass, lesion, or ulcer. Consequently, any suspicious vulvar lesion warrants prompt biopsy to assess for invasive disease. Squamous cell carcinoma is the most prevalent histological subtype of vulvar cancer. The therapeutic approach is primarily guided by histopathological findings and surgical staging. Surgery remains the cornerstone of treatment for early-stage disease, particularly in cases of squamous cell carcinoma. However, for advancedstage tumors, concurrent chemo radiation has demonstrated efficacy and may serve as an appropriate alternative or adjunct to surgery. Optimal management of vulvar cancer necessitates an individualized, multidisciplinary approach, ideally within a specialized cancer center with expertise in the diagnosis and treatment of rare gynecologic malignancies.