Malignant disease conditions 

Primary bone tumours are rare and mostly affect 10–20-year-olds in long bones; osteosarcoma often spreads to the lungs. Diagnose with X-ray, CT/MRI, bone scan and biopsy, and treat with limb-sparing surgery where possible, neoadjuvant cisplatin–doxorubicin (± ifosfamide) chemotherapy for osteosarcoma, and radiotherapy for margins or unresectable disease.

Soft tissue sarcomas (MFH, liposarcoma, leiomyosarcoma, synovial sarcoma, rhabdomyosarcoma in children, GIST) arise from connective tissue and spread mainly to the lungs. Treat with surgery and pre- or post-operative radiotherapy, doxorubicin–ifosfamide-based chemotherapy for high-grade or unresectable disease, and imatinib for GIST.

Cancer of the vulva is a malignant neoplasm arising from the external female genitalia. It is predominantly a disease of older women and most commonly presents as squamous cell carcinoma. In many cases, vulvar cancer develops from premalignant lesions known as vulvar intraepithelial neoplasia (VIN).

Endometrial cancer is a malignant neoplasm arising from the endometrial lining of the uterus and is one of the most common gynecological malignancies in women. It predominantly affects postmenopausal women, although it may occur in younger women with specific risk factors.

Cancer of the uterine cervix is a malignant disease arising from the cervical epithelium and is strongly associated with persistent infection by high-risk types of human papillomavirus (HPV). It is one of the most common cancers affecting women, particularly in low- and middle-income countries.