Diagnostic and therapeutic dilemmas in vulvar cancer

Invasive vulvar cancer is rare. The etiology of vulvar cancer is incompletely understood. Human papilloma virus is known to be the major causal factor. The keystep in the diagnosis is punch biopsy with attention to unifocal or multifocal lesions and involvement of adjacent regions. The therapeutic procedure is based mostly on histomorphologic parameters e.g. unifocal/multifocal lesion, localisation, tumor typing/grading, depth of invasion; the goal of these morphologic and morphometric parameters is to reduce radicality in order to avoid postoperative morbidity without jeopardising the chances of cure. This individualization considers treatment options in both the vulvar and the groin.