<prompt> A woman is found to have a unilateral invasive carcinoma of vulva that is 1 cm in diameter with no stromal invasion and is not associated with evidence of lymph node spread. Initial management should consists of :ChemotherapyRadiation therapyWide excision and Sentinel lymph node biopsyRadical vulvectomy and bilateral inguinal lymphadenectomy  <response>: The patient in question appears to have vulval cancer with stage 1A with unifocal lateral lesion VULVAL CARCINOMA: STAGING AND MANAGEMENT STAGE 1 1A Limited to vulvaperineum Size2cm stromal invasion 1mm Wide local excision sentinel lymph node study 1B Size 2cm stromal invasion 1mm Radical local excision plus BL LAD: central lesion UL LAD: lateral lesion 2cm from midline STAGE 2 Any size ,Spreads to lower 13 urethra, lower 13 vagina, anus Early: radical excision radical vulvectomy plus BL LAD Advanced: radiation surgery LAD STAGE 3 Positive inguinofemoral lymph nodes Radiation surgery LAD STAGE 4A 4B Upper urethra, upper vagina, bladder, rectum, pelvis side wall Distant metastasis, Pelvic or other lymph nodes Radiation surgery LAD LAD lymphadenectomy Radical local excision: excision of entire tumour with at least 1 cm grossly negative margin and extended down to inferior fascia of urogenital diaphragm. Senrinel lymph nodes studies: reliable and suitable in early stage disease with unifocal lesion less than 4 cm and clinically negative lymph nodes on groin examination and imaging. 