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Spread

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Spread of vulvar carcinoma is by:

  • direct extension to adjacent structures - such as vagina, urethra, anus
  • lymphatic embolisation to superficial and deep inguinal nodes
  • haematogenous - to distant sites such as lungs, liver, bone

Lymph node metastases occur in about half of cases, initially on the side of the lesion, but often bilaterally.

Haematogenous spread occurs late and is rare in the absence of lymphatic involvement.

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