{"id":5256,"date":"2024-12-11T17:19:34","date_gmt":"2024-12-11T16:19:34","guid":{"rendered":"https:\/\/irccs.com\/patologie\/tumors-of-the-vulva\/"},"modified":"2026-06-23T12:02:33","modified_gmt":"2026-06-23T10:02:33","slug":"tumors-of-the-vulva","status":"publish","type":"pathology","link":"https:\/\/inoc.it\/en\/pathology\/tumors-of-the-vulva\/","title":{"rendered":"Tumors of the Vulva"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\"><span  id=\"pathology\" class=\"h2_anchor\"><\/span>Pathology<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Vulvar cancer<\/strong> is a relatively rare malignancy, accounting for approximately <strong>3 to 5% of cancers of the female genital tract<\/strong>. In Italy, about <strong>1,200 new cases<\/strong> are diagnosed each year, most of them in <strong>postmenopausal women<\/strong>. Incidence increases with age, with around <strong>90% of diagnoses occurring after the age of 60<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The <strong>vulva<\/strong> is the external portion of the female genital system and includes the <strong>labia majora<\/strong>, <strong>labia minora<\/strong>, <strong>vestibule (vaginal opening)<\/strong>, <strong>clitoris<\/strong>, and <strong>perineum<\/strong>, the area of skin between the vagina and anus. Although vulvar cancer most commonly affects the <strong>labia majora<\/strong>, it can develop in any region of the vulva.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Vulvar cancer typically develops slowly over many years and is often preceded by <strong>pre-invasive lesions<\/strong>, which are cellular changes that are not yet malignant but may progress to cancer over time. These lesions are frequently associated with <strong>human papillomavirus (HPV) infection<\/strong> or with <strong>chronic vulvar dermatoses<\/strong>, such as <strong>lichen sclerosus<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Early detection is essential for a favorable prognosis<\/strong>. When identified at an early stage, vulvar cancer can often be successfully treated, with approximately <strong>3 out of 4 women<\/strong> showing no signs of disease <strong>five years after diagnosis<\/strong>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Types<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Squamous cell carcinoma (85\u201390% of cases):<\/strong> arises from the <strong>squamous cells lining the vulva<\/strong>. <\/li>\n\n\n\n<li><strong>Malignant melanoma (2\u20135% of cases):<\/strong> a <strong>pigmented tumor<\/strong> resembling a dark mole. <\/li>\n\n\n\n<li><strong>Adenocarcinoma (1\u20133% of cases):<\/strong> develops from <strong>Bartholin\u2019s glands<\/strong>. <\/li>\n\n\n\n<li><strong>Other rare tumors:<\/strong> include <strong>sarcomas<\/strong> and <strong>Paget\u2019s carcinoma<\/strong>.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"symptoms\" class=\"h2_anchor\"><\/span>Symptoms<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">In the <strong>early stages<\/strong>, the tumor may be <strong>asymptomatic<\/strong> or mistaken for <strong>benign conditions<\/strong>. Initially, it may present as <strong>skin changes<\/strong>, which can appear <strong>thinner, redder, or darker<\/strong> than the surrounding tissue.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Over time, a <strong>white or red lesion with an irregular surface<\/strong> may develop, sometimes accompanied by <strong>itching, pain, burning<\/strong>, or <strong>small non-healing wounds<\/strong>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"risk-factors\" class=\"h2_anchor\"><\/span>Risk Factors<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">This type of neoplasm usually arises from <strong>precancerous lesions<\/strong> associated with <strong>human papillomavirus (HPV) infection<\/strong> or <strong>chronic inflammatory conditions<\/strong>, such as <strong>genital lichen sclerosus<\/strong>. The main known risk factors include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Age (over 60 years)<\/strong><\/li>\n\n\n\n<li><strong>Human papillomavirus (HPV) infection<\/strong><\/li>\n\n\n\n<li><strong>Cigarette smoking<\/strong><\/li>\n\n\n\n<li>Presence of <strong>lichen sclerosus<\/strong> or other chronic inflammatory conditions (for example, <strong>Paget\u2019s disease<\/strong>)<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Additional factors that may increase the risk include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Weakened immune system<\/strong><\/li>\n\n\n\n<li>Presence of <strong>precancerous lesions (dysplasia)<\/strong> or tumors in other sites, such as the <strong>cervix, vagina, or anus<\/strong><\/li>\n\n\n\n<li><strong>Chronic granulomatous disease<\/strong><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"diagnosis-and-examination\" class=\"h2_anchor\"><\/span>Diagnosis and examination<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The diagnostic pathway for <strong>vulvar cancer<\/strong> begins with a <strong>specialist <a href=\"https:\/\/inoc.it\/en\/medical-area\/gynecologic-oncology-and-hereditary-tumors\/\">gynecological<\/a> examination<\/strong>, during which the physician collects the patient\u2019s <strong>personal and family history<\/strong>, evaluates symptoms, and performs a careful inspection of the <strong>genital and inguinal regions<\/strong>, along with a complete gynecological examination.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If a suspicious lesion is identified, a <strong>biopsy<\/strong> is performed. This involves taking a small tissue sample for <strong>microscopic analysis<\/strong> and is essential to confirm or exclude the presence of cancer with certainty.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In some cases, particularly when the lesion is small or difficult to detect, the specialist may perform <strong>vulvoscopy<\/strong>, an examination that allows a more detailed visualization of the affected area and helps guide tissue sampling.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">To assess the <strong>extent of the disease<\/strong> and possible involvement of the <strong>inguinal lymph nodes<\/strong>, imaging studies may be used, including:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Magnetic Resonance Imaging (MRI)<\/strong><\/li>\n\n\n\n<li><strong>PET\/CT<\/strong><\/li>\n\n\n\n<li><strong>Computed Tomography (CT)<\/strong><\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Early diagnosis and timely treatment are crucial<\/strong>, as identifying the disease at an early stage allows for more effective and targeted therapies.ease is identified, the more effective and targeted the available treatments can be.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Staging<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Vulvar cancer<\/strong> is classified into four stages according to the criteria established by the <strong>International Federation of Gynecology and Obstetrics (FIGO)<\/strong>:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Stage I:<\/strong> The tumor is confined to the <strong>vulva or perineum<\/strong> and has not spread to the lymph nodes.<\/li>\n\n\n\n<li><strong>Stage II:<\/strong> The tumor extends to nearby structures such as the <strong>lower urethra, vagina, or anus<\/strong>, without lymph node involvement.<\/li>\n\n\n\n<li><strong>Stage III:<\/strong> The disease involves <strong>inguinal or femoral lymph nodes<\/strong> and may also invade surrounding tissues.<\/li>\n\n\n\n<li><strong>Stage IV:<\/strong> The tumor is more advanced, may infiltrate deeper structures such as the <strong>bladder or rectum<\/strong>, attach to the <strong>pelvic bone<\/strong>, or give rise to <strong>distant metastases<\/strong>.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">This classification is essential for determining the <strong>extent of the disease<\/strong> and guiding the selection of the most appropriate <strong>treatment strategy<\/strong>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"therapies\" class=\"h2_anchor\"><\/span>Therapies<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">To select the most appropriate treatment for this condition, it is essential to consider the patient\u2019s <strong>age<\/strong>, <strong>pathological features<\/strong>, <strong>type of disease<\/strong>, as well as the <strong>location and extent of the tumor<\/strong>.<\/p>\n\n\n\t<div id=\"block_6a3a59b641120\" class=\"accordion-block acf-block\">\n\t\t<div class=\"my-4 lg:my-6\">\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Pre-cancerous Lesions<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>In cases of <strong data-start=\"43\" data-end=\"67\">precancerous lesions<\/strong>, a <strong data-start=\"71\" data-end=\"96\">conservative approach<\/strong> is often sufficient. Treatment may include <strong data-start=\"140\" data-end=\"157\">laser surgery<\/strong>, which allows for the removal or vaporization of altered cells while preserving surrounding healthy tissue.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Surgical Intervention<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<div class=\"qMYqUG_convSearchResultHighlightRoot\">\n<div class=\"\" data-turn-id-container=\"request-WEB:2f69e866-3ec6-42f8-b022-0d1ff61893ab-37\" data-is-intersecting=\"true\">\n<section class=\"text-token-text-primary w-full focus:outline-none has-data-writing-block:pointer-events-none [&amp;:has([data-writing-block])&gt;*]:pointer-events-auto R6Vx5W_threadScrollVars scroll-mb-[calc(var(--scroll-root-safe-area-inset-bottom,0px)+var(--thread-response-height))] scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]\" dir=\"auto\" data-turn-id=\"request-WEB:2f69e866-3ec6-42f8-b022-0d1ff61893ab-37\" data-turn-id-container=\"request-WEB:2f69e866-3ec6-42f8-b022-0d1ff61893ab-37\" data-testid=\"conversation-turn-76\" data-scroll-anchor=\"false\" data-turn=\"assistant\">\n<div class=\"text-base my-auto mx-auto pb-10 [--thread-content-margin:var(--thread-content-margin-xs,calc(var(--spacing)*4))] @w-sm\/main:[--thread-content-margin:var(--thread-content-margin-sm,calc(var(--spacing)*6))] @w-lg\/main:[--thread-content-margin:var(--thread-content-margin-lg,calc(var(--spacing)*16))] px-(--thread-content-margin)\">\n<div class=\"[--thread-content-max-width:40rem] @w-lg\/main:[--thread-content-max-width:48rem] mx-auto max-w-(--thread-content-max-width) flex-1 group\/turn-messages focus-visible:outline-hidden relative flex w-full min-w-0 flex-col agent-turn\" data-conversation-screenshot-content=\"\">\n<div class=\"flex max-w-full flex-col gap-4 grow\">\n<div class=\"min-h-8 text-message relative flex w-full flex-col items-end gap-2 text-start break-words whitespace-normal outline-none keyboard-focused:focus-ring [.text-message+&amp;]:mt-1\" dir=\"auto\" tabindex=\"0\" data-message-author-role=\"assistant\" data-message-id=\"396bc64c-b860-4c7f-9b97-d362f3b0d321\" data-message-model-slug=\"gpt-5-3-mini\" data-turn-start-message=\"true\">\n<div class=\"flex w-full flex-col gap-1 empty:hidden\">\n<div class=\"markdown prose dark:prose-invert wrap-break-word w-full light markdown-new-styling\">\n<p data-start=\"31\" data-end=\"360\">In cases of <strong data-start=\"43\" data-end=\"69\">invasive vulvar cancer<\/strong>, surgery is the main treatment and serves both a <strong data-start=\"119\" data-end=\"158\">therapeutic and symptomatic purpose<\/strong>. The extent of the procedure depends on the <strong data-start=\"203\" data-end=\"235\">size and spread of the tumor<\/strong>. In many cases, the <strong data-start=\"256\" data-end=\"280\">inguinal lymph nodes<\/strong> must also be removed, as they are the primary route of early metastatic spread.<\/p>\n<p data-start=\"362\" data-end=\"376\">In particular:<\/p>\n<ul data-start=\"378\" data-end=\"875\" data-is-last-node=\"\" data-is-only-node=\"\">\n<li data-section-id=\"8v3mlh\" data-start=\"378\" data-end=\"668\">The <strong data-start=\"384\" data-end=\"407\">sentinel lymph node<\/strong> is the first lymph node to receive lymphatic drainage from the tumor site. Its removal allows assessment of whether the cancer has spread, without the need to remove all regional lymph nodes, thereby reducing the risk of complications such as <strong data-start=\"651\" data-end=\"665\">lymphedema<\/strong>.<\/li>\n<li data-section-id=\"f46izu\" data-start=\"670\" data-end=\"875\" data-is-last-node=\"\">Depending on the <strong data-start=\"689\" data-end=\"713\">stage of the disease<\/strong> and the <strong data-start=\"722\" data-end=\"747\">location of the tumor<\/strong>, it may be necessary to remove all <strong data-start=\"783\" data-end=\"807\">inguinal lymph nodes<\/strong>, either on one side (<strong data-start=\"829\" data-end=\"843\">unilateral<\/strong>) or both sides (<strong data-start=\"860\" data-end=\"873\">bilateral<\/strong>).<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<\/div>\n<\/div>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Post-surgical Reconstruction<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p data-start=\"38\" data-end=\"228\">After a <strong data-start=\"46\" data-end=\"60\">vulvectomy<\/strong> (partial or total removal of the vulva), <strong data-start=\"102\" data-end=\"127\">vulvar reconstruction<\/strong> is of great importance, both for <strong data-start=\"161\" data-end=\"189\">psychological well-being<\/strong> and for improving <strong data-start=\"208\" data-end=\"227\">quality of life<\/strong>.<\/p>\n<p data-start=\"230\" data-end=\"403\" data-is-last-node=\"\" data-is-only-node=\"\">When a large amount of tissue has been removed, the involvement of a <a href=\"https:\/\/inoc.it\/en\/medical-area\/reconstructive-plastic-surgery\/\"><strong data-start=\"299\" data-end=\"318\">plastic surgeon<\/strong><\/a> can help achieve a more <strong data-start=\"343\" data-end=\"402\">functional and aesthetically appropriate reconstruction<\/strong>.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Radiotherapy, Chemotherapy and Other Therapies<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<div class=\"qMYqUG_convSearchResultHighlightRoot\">\n<div class=\"\" data-turn-id-container=\"request-WEB:2f69e866-3ec6-42f8-b022-0d1ff61893ab-39\" data-is-intersecting=\"true\">\n<section class=\"text-token-text-primary w-full focus:outline-none has-data-writing-block:pointer-events-none [&amp;:has([data-writing-block])&gt;*]:pointer-events-auto R6Vx5W_threadScrollVars scroll-mb-[calc(var(--scroll-root-safe-area-inset-bottom,0px)+var(--thread-response-height))] scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]\" dir=\"auto\" data-turn-id=\"request-WEB:2f69e866-3ec6-42f8-b022-0d1ff61893ab-39\" data-turn-id-container=\"request-WEB:2f69e866-3ec6-42f8-b022-0d1ff61893ab-39\" data-testid=\"conversation-turn-80\" data-scroll-anchor=\"false\" data-turn=\"assistant\">\n<div class=\"text-base my-auto mx-auto pb-10 [--thread-content-margin:var(--thread-content-margin-xs,calc(var(--spacing)*4))] @w-sm\/main:[--thread-content-margin:var(--thread-content-margin-sm,calc(var(--spacing)*6))] @w-lg\/main:[--thread-content-margin:var(--thread-content-margin-lg,calc(var(--spacing)*16))] px-(--thread-content-margin)\">\n<div class=\"[--thread-content-max-width:40rem] @w-lg\/main:[--thread-content-max-width:48rem] mx-auto max-w-(--thread-content-max-width) flex-1 group\/turn-messages focus-visible:outline-hidden relative flex w-full min-w-0 flex-col agent-turn\" data-conversation-screenshot-content=\"\">\n<div class=\"flex max-w-full flex-col gap-4 grow\">\n<div class=\"min-h-8 text-message relative flex w-full flex-col items-end gap-2 text-start break-words whitespace-normal outline-none keyboard-focused:focus-ring [.text-message+&amp;]:mt-1\" dir=\"auto\" tabindex=\"0\" data-message-author-role=\"assistant\" data-message-id=\"c12f82ff-03f7-4a8d-9c65-b8db115f4a82\" data-message-model-slug=\"gpt-5-3-mini\" data-turn-start-message=\"true\">\n<div class=\"flex w-full flex-col gap-1 empty:hidden\">\n<div class=\"markdown prose dark:prose-invert wrap-break-word w-full light markdown-new-styling\">\n<p data-start=\"56\" data-end=\"172\">In some cases, <strong data-start=\"71\" data-end=\"128\">surgery is combined with <a href=\"https:\/\/inoc.it\/en\/medical-area\/radiotherapy\/\">radiotherapy<\/a> or chemotherapy<\/strong>, depending on the <strong data-start=\"147\" data-end=\"171\">stage of the disease<\/strong>.<\/p>\n<p data-start=\"174\" data-end=\"396\">In addition, <strong data-start=\"187\" data-end=\"213\">new targeted therapies<\/strong>, designed to act on specific molecular targets in cancer cells, and <strong data-start=\"282\" data-end=\"299\">immunotherapy<\/strong>, which aims to stimulate the immune system against the tumor, are currently under investigation.<\/p>\n<p data-start=\"398\" data-end=\"518\" data-is-last-node=\"\" data-is-only-node=\"\">At present, these approaches are mainly available in <strong data-start=\"451\" data-end=\"476\">experimental settings<\/strong> and may broaden future treatment options.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"z-0 flex min-h-[46px] justify-start\"><\/div>\n<div class=\"mt-3 w-full empty:hidden\">\n<div class=\"text-center\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<\/div>\n<\/div>\n<div class=\"pointer-events-none -mt-px h-px translate-y-[calc(var(--scroll-root-safe-area-inset-bottom)-14*var(--spacing))]\" aria-hidden=\"true\"><\/div>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\n\t<\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"ongoing-support\" class=\"h2_anchor\"><\/span>Ongoing Support<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">At <strong>INOC &#8211; Istituto Nazionale Oncologico Candiolo<\/strong>, we provide\u00a0<strong>continuous support before, during, and after treatment,<\/strong>\u00a0ensuring that each patient is guided and cared for throughout every stage of their treatment journey and recovery.<\/p>\n\n\n\t<div id=\"block_6a3a59b641a05\" class=\"accordion-block acf-block\">\n\t\t<div class=\"my-4 lg:my-6\">\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Psychological Support<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p class=\"isSelectedEnd\">A\u00a0<strong>cancer diagnosis affects<\/strong>\u00a0not only physical health but\u00a0<strong>also emotional and psychological well-being.<\/strong>\u00a0Coping with cancer is often a profoundly challenging experience that can give rise to feelings of anxiety, fear, anger, and depression.<\/p>\n<p class=\"isSelectedEnd\">At <strong>INOC &#8211; Istituto Nazionale Oncologico Candiolo<\/strong>, psychological support is an integral part of the care pathway. Alongside advanced medical treatments, patients have access to\u00a0<strong>qualified psycho-oncological support<\/strong>\u00a0designed to help them navigate the emotional challenges associated with diagnosis, treatment, and recovery.<\/p>\n<p>Patients may also participate in\u00a0<strong>psychological support groups,<\/strong>\u00a0providing an opportunity to share experiences, receive mutual support, and connect with others who are facing or have faced similar challenges.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Management of Emergencies and Treatment-Related Side Effects<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p class=\"isSelectedEnd\">Cancer patients often require ongoing medical support throughout their treatment journey. When symptoms arise, whether related to the disease itself or to treatment-related side effects, it is important that they can <strong>promptly access specialist advice<\/strong> through a dedicated <strong>fast-track pathway.<\/strong><\/p>\n<p>For this reason, <strong>INOC &#8211; Istituto Nazionale Oncologico Candiolo<\/strong>\u00a0provides a dedicated support service\u00a0<strong>Monday through Friday<\/strong>, from\u00a0<strong>8:00 a.m. to 5:00 p.m.<\/strong>\u00a0Patients can contact the\u00a0<a href=\"https:\/\/inoc.it\/en\/medical-area\/oncology-day-hospital\/\">Oncology Day Hospital<\/a>\u00a0Secretariat at\u00a0<strong>+39 011 993 3775<\/strong>\u00a0to request an urgent consultation. Following the request, the patient is promptly contacted by their specialist physician for assessment and guidance.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">    Supportive and Palliative Care<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p class=\"isSelectedEnd\">Cancer patients often have\u00a0<strong>complex needs<\/strong>\u00a0that extend beyond the treatment of the disease itself and require comprehensive,<strong>\u00a0multidisciplinary care.<\/strong><\/p>\n<p class=\"isSelectedEnd\">At the\u00a0<strong>INOC &#8211; Istituto Nazionale Oncologico Candiolo<\/strong>, patients who need additional support have access to specialists from a range of disciplines, ensuring personalized management of cancer-related symptoms and associated conditions. Services may include nutritional counseling, physical rehabilitation, pain management, and support for other medical needs that may arise during the course of treatment and recovery.<\/p>\n<p>The goal is to\u00a0<strong>improve quality of life, promote overall well-being, and provide comprehensive care<\/strong>\u00a0tailored to each patient\u2019s individual needs.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Follow-up<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p data-start=\"19\" data-end=\"247\">After completion of treatment, <strong data-start=\"50\" data-end=\"76\">follow-up is essential<\/strong> to monitor the patient\u2019s health and allow for early detection of any <strong data-start=\"146\" data-end=\"160\">recurrence<\/strong>. European gynecologic oncology guidelines (<strong data-start=\"204\" data-end=\"212\">ESGO<\/strong>) recommend the following schedule:<\/p>\n<ul data-start=\"249\" data-end=\"633\">\n<li data-section-id=\"yxypv2\" data-start=\"249\" data-end=\"382\"><strong data-start=\"251\" data-end=\"276\">Gynecological visits:<\/strong> every <strong data-start=\"283\" data-end=\"297\">3\u20136 months<\/strong> during the first two years, then every <strong data-start=\"337\" data-end=\"349\">6 months<\/strong> for the following three years.<\/li>\n<li data-section-id=\"dkwm9\" data-start=\"383\" data-end=\"456\"><strong data-start=\"385\" data-end=\"398\">Pap test:<\/strong> once a year to assess the health of <strong data-start=\"435\" data-end=\"453\">cervical cells<\/strong>.<\/li>\n<li data-section-id=\"1mgky6c\" data-start=\"457\" data-end=\"633\"><strong data-start=\"459\" data-end=\"492\">Instrumental and blood tests:<\/strong> such as <strong data-start=\"501\" data-end=\"532\">ultrasound, CT scan, or MRI<\/strong>, performed only when clinically indicated by the physician, depending on symptoms and disease stage.<\/li>\n<\/ul>\n<p data-start=\"635\" data-end=\"770\" data-is-last-node=\"\" data-is-only-node=\"\"><strong data-start=\"635\" data-end=\"661\">Personalized follow-up<\/strong> allows for early intervention in case of new findings and ensures safe, long-term monitoring of the patient.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Social Work Services<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p data-start=\"26\" data-end=\"278\">The Social Work Service at INOC &#8211; Istituto Nazionale Oncologico Candiolo provides information, guidance, and support to patients and their families regarding access to community services and the welfare and social security benefits available under current legislation.<\/p>\n<p data-start=\"280\" data-end=\"491\">During dedicated consultations, social workers assist with matters such as disability recognition, access to aids and prosthetic devices, employment-related benefits and leave, and other social support services.<\/p>\n<p data-start=\"493\" data-end=\"621\" data-is-last-node=\"\" data-is-only-node=\"\">The service is available on\u00a0<strong data-start=\"521\" data-end=\"575\">Wednesdays and Fridays from 9:00 a.m. to 1:00 p.m.<\/strong>\u00a0and can be contacted at\u00a0<strong data-start=\"600\" data-end=\"620\">+39 011 993 3059<\/strong>.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\n\t<\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"multi-disciplinary-team\" class=\"h2_anchor\"><\/span>Multi Disciplinary Team<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Every cancer requires a&nbsp;<strong>multidisciplinary approach<\/strong>&nbsp;at all stages of disease management. At INOC &#8211; Istituto Nazionale Oncologico Candiolo, this is provided by a team of specialists from various clinical and surgical departments, known as the&nbsp;<strong>GIC<\/strong>, Interdisciplinary Care Group (or MDT). The GIC ensures that each patient is supported throughout the diagnostic and therapeutic process, including arranging and coordinating examinations and maintaining communication with the patient and their family.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For each patient, the GIC (MDT) defines and shares a personalized care pathway based not only on the type and stage of the tumor but also on the patient\u2019s individual characteristics. The goal is to achieve the best possible outcomes both oncologically and functionally, while maintaining a high quality of life.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The Group<strong>&nbsp;also collaborates closely with the Institute\u2019s researchers<\/strong>&nbsp;to provide patients with rapid access to the latest innovations in screening, diagnosis, and treatment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"clinical-divisions\" class=\"h2_anchor\"><\/span>Clinical Divisions<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The diagnostic and therapeutic pathway for vulvar cancer at <strong>INOC \u2013 Istituto Nazionale Oncologico Candiolo <\/strong>involves several clinical divisions, including:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/inoc.it\/en\/medical-area\/ovarian-cancer-center\/\" type=\"medical-area\" id=\"5148\">Ovarian Cancer Center<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/inoc.it\/en\/medical-area\/gynecologic-oncology-and-hereditary-tumors\/\">Gynecology Oncology and Hereditary Tumors<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/inoc.it\/en\/medical-area\/medical-oncology\/\" type=\"medical-area\" id=\"5169\">Medical Oncology<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/inoc.it\/en\/medical-area\/anesthesia-and-resuscitation\/\" type=\"medical-area\" id=\"5185\">Anesthesia and Resuscitation<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/inoc.it\/en\/medical-area\/reconstructive-plastic-surgery\/\" type=\"medical-area\" id=\"5159\">Reconstructive Plastic Surgery<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/inoc.it\/en\/medical-area\/nuclear-medicine\/\" type=\"medical-area\" id=\"5106\">Nuclear Medicine<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/inoc.it\/en\/medical-area\/radiotherapy\/\" type=\"medical-area\" id=\"5104\">Radiotherapy<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/inoc.it\/en\/medical-area\/radiodiagnostics\/\" type=\"medical-area\" id=\"5101\">Radiodiagnostics<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/inoc.it\/en\/medical-area\/pathologic-anatomy\/\" type=\"medical-area\" id=\"5118\">Anatomical Pathology<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"clinical-studies\" class=\"h2_anchor\"><\/span>Clinical Studies<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Researchers at <strong>INOC \u2013 Istituto Nazionale Oncologico Candiolo <\/strong>are currently involved in several national and international projects on <strong>gynecological cancers<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The main activities include <strong>clinical, translational, and molecular research<\/strong>, as well as numerous <strong>experimental clinical trials<\/strong> evaluating new <strong>chemotherapy drugs<\/strong> and <strong>immunotherapy approaches<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In addition, <strong>experimental surgical protocols<\/strong> are underway focusing on <strong>lymph node staging in cervical cancer<\/strong>, including the use of the <strong>sentinel lymph node technique<\/strong>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"why-choose-us\" class=\"h2_anchor\"><\/span>Why Choose Us<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">At <strong>INOC \u2013 Istituto Nazionale Oncologico Candiolo<\/strong>, every patient with <strong>vulvar cancer<\/strong> is managed according to highly specialized standards, through the coordinated work of a dedicated <a href=\"https:\/\/inoc.it\/en\/pathology\/tumors-of-the-vulva\/#multi-disciplinary-team\"><strong>Interdisciplinary Care Group (GIC)<\/strong>.<\/a><\/p>\n\n\n\t<div id=\"block_6a3a59b641a5e\" class=\"accordion-block acf-block\">\n\t\t<div class=\"my-4 lg:my-6\">\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Clinical Experience and Tailored Approach<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>Thanks to the large number of cancer cases treated each year, INOC &#8211; Istituto Nazionale Oncologico Candiolo is a\u00a0<strong>national reference<\/strong>\u00a0center for the care of this disease. This extensive experience allows us to manage even the most complex cases, always using a\u00a0<strong>personalized approach<\/strong>, tailored to the clinical and individual profile of each patient.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Imaging Technologies and Advanced Diagnostics<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>Establishing a treatment plan always begins with an accurate and timely diagnosis. Patients have access to\u00a0<strong>state-of-the-art imaging technologies<\/strong>, such as ultrasound, contrast-enhanced CT, MRI, and cholangio-RM, which are critical for accurately assessing the extent of the tumor.<\/p>\n<p><strong>Advanced laboratory tests<\/strong>, including molecular analyses, are also available to help define biological features of the disease and guide treatment choices.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Minimally Invasive Surgical Techniques and Multidisciplinarity<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>When appropriate, surgeries are performed using\u00a0<strong data-start=\"244\" data-end=\"268\">minimally invasive<\/strong>, laparoscopic or robotic\u00a0<strong data-start=\"244\" data-end=\"268\">techniques<\/strong>. These approaches involve the use of camera-equipped instruments introduced into the abdomen through small incisions, thus reducing surgical trauma.\u00a0<strong>Benefits<\/strong>\u00a0to the patient include\u00a0<strong>shorter hospital stay times, faster recovery, and lower risk of complications compared with traditional open surgery.<\/strong><\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Clinical Research and Access to Trials<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<h3 class=\"wp-block-heading\"><\/h3>\n<p><!-- \/wp:heading --><\/p>\n<p>As an IRCCS (Scientific Institute for Research, Hospitalization, and Healthcare), INOC &#8211; Istituto Nazionale Oncologico Candiolo combines clinical care with a strong focus on scientific research. Patients can be considered for <strong><a href=\"https:\/\/inoc.it\/en\/pathology\/tumors-of-the-vulva\/#clinical-studies\">participation in active clinical trials<\/a><\/strong>, offering access to innovative therapies not yet available in standard practice. This integration of care and research is a distinctive strength that translates into tangible benefits for patients.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Care and Support Every Step of the Way<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>The Interdisciplinary Care Group (GIC or MDT)\u00a0<a href=\"https:\/\/inoc.it\/en\/pathology\/tumors-of-the-vulva\/#multi-disciplinary-team\"><strong>supports th<\/strong><\/a><a href=\"https:\/\/inoc.it\/en\/pathology\/cervical-cancer\/#multi-disciplinary-team\"><strong>e patient at every stage<\/strong><\/a>: from diagnosis, through treatment, to follow-up. Special attention is paid to<strong>\u00a0nutritional support, psychological health and reintegration into daily life.<\/strong>\u00a0The organization of checkups, examinations, and treatment is designed to ensure\u00a0<strong>continuity, serenity, and a humane, caring<\/strong>\u00a0approach to each patient\u2019s needs.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\n\t<\/div>\n","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"class_list":["post-5256","pathology","type-pathology","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - 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