<prompt> True about carcinoma vulvaSpreads to superficial inguinal nodes and Radiotherapy givenSpreads to iliac nodesSeen after menopause and Viral predispositionAll  <response>: Ans. is a, b and c i.e. Spreads to superficial inguinal nodes: Spreads to iliac nodes: Seen after menopause; Viral predisposition; and Radiotherapy given Vulva cancer : 2 - 4 of all malignancies of female genital tract. Age : occurs in 6 or 7 decade. Most common histologic type is epidermoid cancer squamous cell CA Nulliparous, women of low parity are predisposed to vulva, CA. The etiology is same as of carcinoma in situ cervix that is viral predisposition by viurses - HIV, HPV, HSV-I1. Most common site - Labium majora followed by clitorus and labium minora. Associated with cervical and ovarian CA in 20 case. Presents with pruritus, vulva! swelling, lump or ulcer. Spread of tumor - mainly by direct spread and lymphatics. First superficial inguinal nodes are involved and then spreads to deep nodes and glands of Cloquet to external iliac nodes, obturator and common iliac nodes in late stages. Treatment : - Early stages : vulvectomy with inguinal nodes dissection. - Late stages : chemotherapy and radiotherapy. 