CANCER DE LA VULVE A PROPOS DE 20 CAS

Vulvar cancer is a rare pathology which represents 3 to 5% of gynecological tumors (1) it mainly affects older women with estrogen deficiency (2). The objective of our study is to describe the epidemiological profile, to report the clinical anatomy, the therapies and the prognosis with a view to discussing them in the light of literature data, and to draw conclusions for better therapeutic charge. Twenty cases of vulvar cancer diagnosed and treated within the obstetrics and gynecology department I, Hassan II university hospital center, Fez, were retrospectively analyzed over a period spread over thirteen years from June 2009 to June 2022. 65% of our patients had an age around 60 years, the perception of a vulvar tumor and the notion of vulvar pruritus were the predominant revealing clinical signs. 60% of patients consulted after a period of 6 months, FIGO stages I and III were predominant with frequency of 40 and 35% respectively. Squamous cell carcinoma is the most common histological type in our study found in 90% of cases. Therapeutically, 80% of cases underwent radical total vulvectomy with bilateral inguinofemoral lymph node dissection followed by radiotherapy in 50% of cases. 4 cases of local recurrences were recorded in our series and 1 case of lymph node recurrence of a vulvar melanoma with distant metastases, 6 cases of death were reported in different tables. In conclusion, raising awareness of the population as well as clinicians about precancerous lesions makes it possible to optimize early diagnosis and promote conservative treatment.