A 63-year-old has a 3.2 cm unifocal vulval SCC, depth of invasion 4 mm, no suspicious groin nodes, but the lesion extends into the distal urethra so

Question

A 63-year-old has a 3.2 cm unifocal vulval SCC, depth of invasion 4 mm, no suspicious groin nodes, but the lesion extends into the distal urethra so representative perilesional mapping is not possible. What is the appropriate groin-staging principle?

Accepted Answer

Do not use sentinel-node biopsy; proceed to inguinofemoral nodal staging because representative injection is not possible

Answer

Excise the primary tumour first, then perform delayed sentinel-node mapping around the surgical scar before deciding on groin dissection

Answer

Use unilateral sentinel-node biopsy because a unifocal lesion under 4 cm fulfils all necessary eligibility criteria

Answer

Omit groin-node staging because negative examination and imaging exclude clinically important occult metastasis

Answer

Use serial groin ultrasonography rather than surgical staging because the lesion is unifocal and imaging is negative

Vulval Cancer — SCE Medical Oncology MCQ

A 63-year-old has a 3.2 cm unifocal vulval SCC, depth of invasion 4 mm, no suspicious groin nodes, but the lesion extends into the distal urethra so representative perilesional mapping is not possible. What is the appropriate groin-staging principle?