ABSTRACT
Introduction ........................................................................................................................ 142 Epidem iology ...................................................................................................................... 143 Anatomy and Lymphatic D rain age .............................................................................. 144 Surgical M anagement and Staging o f Vulvar C arcinom a ....................................... 144 Intraoperative Lymphatic M apping fo r Vulvar C arc in om a ................................... 147 Technique o f Vulvar Lym phoscintigraphy ................................................................... 147 Vulvar M elan om a .............................................................................................................. 148 Conclusion and the F u tu re ............................................................................................. 148
INTRODUCTION
Overall, carcinoma of the vulva is a relatively rare malignancy representing approximately 5% of all female genital tract cancers1 and 1% of all malignancies in women. The incidence has risen slightly over the past 50 years, perhaps because o f an overall rise in the average age o f women in the U.S.,2 or an increase in the prevalence of human papillomavirus (HPV) genital tract infection. The reported increase in vulvar carcinoma in situ, a precursor lesion, has nearly doubled from 1.1-2.1 per 100,000 woman-years between 1973 and 1987,3,4 mostly in younger women.
