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Vulval cancer — DRCOG MCQ

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HardGynaecologyVulval cancerDRCOG

A 50-year-old woman has vulval soreness and a single persistent ulcerated lesion on the labium majus for 6 weeks. It has not improved with topical antifungal treatment. She has no previous genital herpes. When should this patient be referred?

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

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Correct answer: E — Refer urgently on a suspected cancer pathway

A persistent unexplained vulval ulcer or lesion should be referred urgently because vulval cancer or VIN must be excluded. Continuing empirical antifungal treatment risks diagnostic delay. The teaching point is that persistent vulval symptoms require inspection and a low threshold for biopsy/referral.

Reference: NICE NG12; RCOG vulval cancer guidance