In patients with perianal squamous cell carcinoma extending to the vulva, would you cover the entire vulva or would generous margins on the gross disease suffice?   

I would generally favor treating with generous margins as opposed to intentionally covering the entire vulva. However, for patients who have a prior history of vulvar lichen sclerosis or vulvar intraepithelial neoplasia where the risk of developing vulvar cancer is higher, I would consider covering ...

I agree with Dr. @Miller's response. I would manage this perianal SCC like an anal canal cancer - with generous margins and without inclusion of the entire vulva. As stated above, 2.5 cm margins were used in clinical trials including RTOG 98-11 and RTOG 0529, which is already quite generous. A PET/C...

Agree with the previous answers. These are sometimes challenging presentations with lots of nuances. In the perianal squamous cell carcinoma patients who do not have involvement of the anal canal, I would include generous margins on the lesion including into the anal canal, but I would not treat the...

I would also agree with previous answers by @Eric D. Miller and @Leila Tchelebi and one has to perform a careful clinical exam of the peri-anal skin and vulva to identify VIN, lichen sclerosis, and extent of the tumor. I would consider covering the entire vulva (but not the mons). Also use of TLD o...