How is presentation of vulva carcinoma?

➢ VIN and early vulvar carcinomas commonly manifest as areas of leukoplakia. ➢ In about 25% of the cases, the lesions are pigmented owing to the presence of melanin. ➢ With time, these areas are transformed into overt exophytic or ulcerative endophytic tumors. ➢ HPV-positive tumors are often multifocal and warty and tend to be poorly differentiated SqCC ➢ Whereas HPV-negative tumors usually are unifocal and typically are well-differentiated keratinizing SqCC ➢ The risk of metastasis correlates with the depth of invasion.