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Vulval cancer — DRCOG MCQ

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ModerateGynaecological OncologyVulval cancerDRCOG

A 72-year-old woman has a persistent vulval ulcer and itching for 3 months. Examination shows a firm irregular lesion on the labium majus. Topical antifungal treatment has not helped. When should this patient be referred?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Refer urgently for suspected vulval cancer

A persistent firm vulval ulcer or lesion in an older woman should prompt urgent suspected cancer referral. Thrush is usually itchy with discharge or erythema and should respond to appropriate treatment. Rarity does not justify delaying referral when examination is suspicious. Biopsy is needed to establish diagnosis.

Reference: NICE NG12; NICE CKS gynaecological cancers