There are a number of different types of vulval cancer. The most common type is squamous cell.
Your doctor will take a sample of tissue to find out which type of vulval cancer you have. This is called a biopsy. It goes to a laboratory, where a specialist doctor looks at it closely under a microscope. The doctor is called a pathologist.
The cells of the different types of vulval cancer look different so the pathologist is usually able to tell which type you have.
Squamous cell carcinoma
Squamous cell is the most common type of vulval cancer. About 90 out of 100 vulval cancers (90%) are this type. This type of cancer usually forms slowly over many years.
Most squamous cell cancers start on the outer lips of the vulva (labia majora). But it can also start in the inner lips (labia minora), clitoris, and perineum.
Before it develops, there might be precancerous changes in the cells of the vulva. These can be there for several years.
This is the second most common type of vulval cancer. About 9 out of every 100 vulval cancers (9%) are melanomas.
It is most often found in women older than 50. Melanomas develop from the skin cells that give the skin its colour by producing pigment.
White women are at higher risk of vulval melanoma than black women.
The signs and symptoms of vulval melanoma can include:
- bleeding and pain
- a change in colour (pigment) in any part of the vulva
Fewer than 1 out of every 100 vulval cancers (1%) are sarcomas. Sarcomas are cancers that start in tissue such as muscle or fat under the skin. These cancers tend to grow quite quickly.
There are several different types of sarcomas that can affect the vulva. They include:
- malignant fibrous histiosarcoma
- epithelioid sarcomas
These are different types of sarcoma which develop from different types of body tissues. Leiomyosarcomas and rhabdomyosarcomas are both muscle tumours. Angiosarcomas begin in the cells of the blood vessels (veins, arteries or capillaries).
Paget’s disease of the vulva
This is a rare type of skin cancer. It usually affects the surface of the skin of the vulva and is slow growing. It is generally seen in women over the age of 50.
Paget’s disease of the vulva causes itching, and it may appear red and flaky. You usually have a biopsy to confirm the diagnosis. Treatment includes:
- surgery with a wide local excision
- imiquimod cream
- photodynamic therapy (PDT)
This is also known as extramammary Paget’s disease as it is similar to Paget’s disease of the breast.
A small number of vulval cancers develop from glands in the vulval skin. These are called adenocarcinomas.
An example of this is Bartholin’s gland cancer. The Bartholin’s glands are 2 small mucous producing glands at the opening of the vagina. They make a fluid which acts as a lubricant during sexual intercourse.
This type of vulval cancer is extremely rare and usually treated with surgery.
Basal cell carcinoma
A small number of vulval cancers are basal cell carcinomas. This type of cancer develops from the deepest layer of skin cells called the basal cells.
This type of cancer is very rare. It looks like a large wart and is a slow growing type of squamous cell carcinoma.