Vulval carcinoma metastasizes to which lymph group :

Ans. is b i.e. Superficial inguinal lymph nodes Vulvar cancer spreads by the following routes : Direct extension, to involve adjacent structures such as the vagina, urethra, and anus Hematogenous spread to distant sites, including the lungs, liver, and bone Lymphatic embolization : At first the superficial inguinal nodes are involved through lymphatic emboli, but later lymphatic channel permeation is seen. The malignancy spreads to deep nodes. and gland of Cloquet to the external iliac glands, obturator and common iliac nodes, in the late stages. Thus inguinal, femoral and pelvic lymph nodes are involved in vulvar cancer. But most impoant amongst these are inguinal-femoral nodes. "The overall incidence of inguinal-femoral lymph node metastasis is repoed to be about 30%. Metastasis to pelvic nodes occur in about 12% of cases. Pelvic nodal metastasis are rare (0.6%) in the absence of groin node involvement."