ABSTRACT
Vulvar cancer is rare, accounting for 5% of all gynecologic malignancies. In general, imaging in vulvar cancer has a limited role. Approximately 90% of vaginal cancers are squamous cell carcinomas. Most vaginal cancers occur in postmenopausal women, and diagnosis is mainly based on clinical findings and directed biopsy. In vaginal cancer, imaging techniques such as magnetic resonance imaging (MRI) or computed tomography (CT) scan may have a role for local staging and preoperative assessment of the disease. On MRI the tumor shows intermediate signal intensity on T1-weighted MRI and high signal intensity on T2-weighted MRI sequences. MRI is more useful for assessing local spread, whereas CT scan is preferred for detecting lymph node and metastatic disease. Ultrasound is also useful for guiding fine needle aspiration (FNA) of inguinal lymph nodes to detect metastatic disease. Ultrasound-guided FNA offers a good sensitivity (72%–93%) with a high specificity (82%–100%).
