Vulva mass

34 yrs old female P2L2 KNOWN PATIENT WITH HIV SINCE 2004 ON REGULAR MEDICATION CURRENTLY ON TLD Patient came with a chief complain of painless vulva mass. For 1 year started gradual Progressive increasing with time which prior started as single small nodule and later on Progressive lead to this leasio. It is associated with pruritus with foul smell discharge however no bleeding. vagina orifice is intact but had lost sexual desire for a while now and she had her last menses in 25 october 2020 She can urinate normal . History No prior family history of the same illness. She denied history of smoking and alcohol drinking. No prior history of multiple sexual partner No history prior of malignancy She attained Menache at age of 15 yrs. No prior history of vaccination aganist hpv 16 and 18 She had normal menstrual cycle of 28days. Vitals Bp 112/76mmhg Pr 98 Spo2 96% Temp 36.0 Physical Examination Mass was tender on touching. Not bleeding. With both urethra and vagina orifice intact. Doesnt extend to the mons pubis upward and vagina downward it is firm on touch and fixed. Investigations Investigation still not yet done. Hb only was taken on arrival being 106g/l Diagnosis Ddx. Squamosu cell carcinoma vulva Genital wart Hpv 16 and 18 Verrucous carcinoma Management Please can i have your Opinion on Managements

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Squamous cell carcinoma Typical cauliflower proliferative growth from vulval skin . Take a biopsy to confirm the diagnosis Also get a CECT of to look for any intra-abdominal metastasis. A wide surgical excision followed by radiotherapy is indicated Chemotherapy- only if there is some evidence of distant metastasis

Good suggestion
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? HIV .. POSITIVE CASE.. WITH.. PROLIFERATIVE .. FOUL .. SMELLING GROWTH.. SUGGESTIVE OF.. MALIGNANCY.. SCC .. NEED'S.. ONCOLOGISTS OPINION.. SURGICAL INTERVENTION.. CHEMOTHERAPY.. RADIOTHERAPY.. HPE..STUDY..

Tnx Dr Shivraj Agarwal sir
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Progressively increasing growth seen on pvt parts is suggestive of malignancy CA cervix get confirm by hpe Rx hysterectomy Followed by chemotherapy

Thanx dr Kute Ankush
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In squamous cell carcinoma Radicalsurgery of vulva + Chemotherapy + Radiotherapy In genital warts Lacer Surgery Berry IUD carcinoma Surgery + Radiotherapy

SCC. Radical surgery.. This may be followed by radiation therapy. Sometimes chemotherapy (chemo) is given along with the radiation to help it work better.
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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

Squamous cell carcinoma Histopathology examination Consult oncologist

SCC. Radical surgery of Vulva. This may be followed by radiation therapy. Sometimes chemotherapy (chemo) is given along with the radiation to help it work better.

Dx Carcinoma Rx 1): Bilwadi + Dadimastak+ Khun Kharaba + musta+ Lodhrapathani churan +moch ras churan + amrita satva: 2 tsp BD A/F. 2): Bol Badh Ras+ kankayan vati + CPV: 1 each BD B/F 3): When the bleeding stops and when patient gains some bala then would prefer "Piccha vasti" with moch ras and yastimadhu with jatyadi ghrita. 4): Avoidance of pittavardhak ahara and vihara. Hope this might help the patient. Chemotherapy must be continued.

Proliferative mass from vagina in a known HIV positive ? Squamous cell carcinoma

Needs histopathology report for Squamous cell carcinoma May be Bartholin cyst also

Thanks Dr. Kute Ankush, Dr. Shivraj Agrawal, Dr. Mandakini Naikwade, Dr. Anil Gangani, Dr. Pushker Bhomia
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