The vulva is the outer part of the female genitals. The vulva includes the opening of the vagina (sometimes called the vestibule), the labia majora (outer lips), the labia minora (inner lips), and the clitoris.

Around the opening of the vagina, there are 2 sets of skin folds. The inner set, called the labia minora, are small and hairless. The outer set, the labia majora, are larger, with hair on the outer surface. These inner and outer labia (Latin for lips) meet, protecting the vaginal opening and, just above it, the opening of the urethra (the short tube that carries urine from the bladder). The Bartholin glands are found just inside the opening of the vagina -- one on each side. These glands produce a mucus-like fluid that acts as a lubricant during sex.

At the front of the vagina, the labia minora meet to form a fold or small hood of skin called the prepuce. The clitoris is beneath the prepuce. The clitoris is an approximately ¾-inch structure of highly sensitive tissue that becomes swollen with blood during sexual stimulation. The labia minora also meet at a place just beneath the vaginal opening, at the fourchette. Beyond the fourchette is the anus, the opening to the rectum. The space between the vagina and the anus is called the perineum.

Cancer of the vulva (also known as vulvar cancer) most often affects the inner edges of the labia majora or the labia minora. Less often, cancer occurs on the clitoris or in the Bartholin glands.

Types of vulvar cancer

Squamous cell carcinomas

Most cancers of the vulva are squamous cell carcinomas. This type of cancer begins in squamous cells, the main type of skin cells. Verrucous carcinoma is a slow-growing subtype of squamous cell carcinoma. This cancer looks like a large wart and a biopsy is needed to determine it is not a benign (non-cancerous) growth. This form of vulvar cancer tends to have a good prognosis (outlook).

Adenocarcinoma

About 8% of vulvar cancers are adenocarcinomas, the type of cancer that develops in gland cells. Vulvar adenocarcinomas most often start in cells of the Bartholin glands. These glands are found just inside the opening of the vagina. A Bartholin gland cancer is easily mistaken for a cyst (accumulation of fluid in the gland), so a delay in accurate diagnosis is common. Most Bartholin gland cancers are adenocarcinomas. Adenocarcinomas can also form in the sweat glands of the vulvar skin.

Paget disease of the vulva is a condition in which adenocarcinoma cells are found in the top layer of the vulvar skin. Up to 25% of patients with vulvar Paget disease also have an invasive vulvar adenocarcinoma (in a Bartholin gland or sweat gland). In the remaining patients, the cancer cells are found only in the skin's top layer and have not grown into the tissues below.

Melanoma

Another type of vulvar cancer is melanoma. Melanomas develop from the pigment-producing cells that give skin color. About 5% to 8% of melanomas in women occur on the vulva, usually on the labia minora and clitoris. More information about melanoma can be found in our document Melanoma Skin Cancer.

Sarcoma

Less than 2% of vulvar cancers are sarcomas, tumors of the connective tissues under the skin that tend to grow rapidly. Unlike other cancers of the vulva, vulvar sarcomas can occur in females at any age, including in childhood.

Basal cell carcinoma

Basal cell carcinoma, the most common type of skin cancer, is more often found on sun-exposed areas of the skin. It occurs very rarely on the vulva. It is discussed further in our document Basal and Squamous Cell Skin Cancer.

Last Medical Review: 12/30/2008
Last Revised: 05/14/2009