Overview
Vulvar and vaginal carcinomas are uncommon diseases that generally affect post‐menopausal women, although 19% of vulvar carcinomas occur in women >50 years old. Risk factors for vulvar cancer include human papilloma virus and chronic inflammation. Vulvar intraepithelial neoplasia can often be managed with wide local excision, but several other modalities have been utilized. Most vulvar malignancies are squamous cell carcinomas that are managed by surgical excision and radiotherapy. Sentinel lymph node biopsy has been used to spare the morbidity observed after regional lymph node dissection. For more advanced lesions, chemo‐radiotherapy with agents such as 5‐FU, cisplatin, and mitomycin C is utilized. Other vulvar malignancies include Bartholin gland carcinomas, basal cell carcinomas, verrucous carcinomas, and melanomas. Carcinomas of the vagina are most frequently squamous cell, but clear cell adenocarcinomas have been seen in younger women. In the past, clear cell carcinomas were associated with prenatal exposure to diethyl‐stibestrol. Vaginal melanomas can occur, as well as endodermal sinus tumors, rhrabdomysarcomas, and fibroepithelial vagina polyps.