A 72-year-old patient with multicentric carcinoma in situ (CIS)of the vulva,without evidence of leukoplakia and pruritus is scheduled for surgery.She has a history of prior papillomavirus infection.Select the most appropriate surgical option.

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Simple vulvectomy is removal of the labia majora and labia minora,possibly but not preferably the glans clitoris,and occasionally tissue from the perianal area.A simple vulvectomy is usually done to treat CIS of the vulva when it is multicentric.Rarely a superficial vulvectomy is necessary for the treatment of either leukoplakia or intractable pruritus.

A 72-Year-Old Patient with Multicentric Carcinoma in Situ (CIS)of the Vulva,without