What is the most common presenting symptom of vulvar cancer?

• A. Pelvic pain
• B. Abnormal vaginal bleeding
• C. Vulvar pruritus
• D. Weight loss

Answer: (C)

Persistent itching of the vulva is the most common presenting symptom of vulvar cancer. This itching occurs because cancerous changes in the vulvar skin often cause chronic irritation and inflammation, producing an itch that prompts women to seek evaluation. Patients may mistake it for eczema, dermatitis, or a fungal infection, which can delay diagnosis, but itching tends to be the earliest and most frequent signal of vulvar pathology. As the disease progresses, a visible lesion or mass may appear and other symptoms like bleeding or pain can develop, but those are less common as the initial sign. Weight loss and pelvic pain are more typically associated with advanced disease or other cancers, not the typical early vulvar cancer presentation.