ACR Appropriateness Criteria® Management of Locoregionally Advanced Squamous Cell Carcinoma of the Vulva

Kidd, Elizabeth A.; Moore, David H.; Varia, Mahesh A.; Gaffney, David K.; Elshaikh, Mohamed A.; Erickson, Beth; Jhingran, Anuja; Lee, Larissa J.; Mayr, Nina A.; Puthawala, Ajmel; Rao, Gautam; Small, William; Wahl, Andrew O.; Wolfson, Aaron H.; Yashar, Catheryn M.; Yuh, William T. C.; Cárdenes, Higinia R.

doi:10.1097/coc.0b013e318295af1d

Cited by 21 publications

(3 citation statements)

References 38 publications

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“…15 Certain strains of HPV are known to be more oncogenic than others. HPV types 16,18,31,33,35,45, and 54 are more likely to be associated with cervical neoplasia and cancer and are suspected to also be responsible for vulvar cancers. 15 The DNA from HPV 16 and 18 has been detected in up to 60% of patients with vulvar cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Adjuvant radiotherapy is recommended in high-risk cases with tumour size over 4 cm, lymphovascular invasion, lymph node invasion and close or positive surgical margins. 33 Radiotherapy of the inguinal region is also indicated in patients that have only an invaded lymph node. 6 In our patient, as MRI pelvis with contrast after 2 months of surgery did not show any lymph node involvement or any residual disease, hence adjuvant radiotherapy was not required.…”

Section: Discussionmentioning

confidence: 99%

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Radical vulvectomy for a rare case of squamous cell carcinoma vulva: a case report

Nahar

2021

Int J Reprod Contracept Obstet Gynecol

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Cancer of the vulva is the fourth most common malignancy of the female genital tract. Vulvar carcinoma is a rare and aggressive gynecological malignancy. It affects elderly females, with the mean age at diagnosis being 55-60 years. Regional metastasis to inguinal lymph nodes is common. There is a high incidence of pelvic node involvement, especially in those with pathologically positive inguinal nodes. Surgery appears to be the only curative treatment option in the early stages of the disease. But in most patients, surgery is associated with considerable morbidities and psychosexual issues. Hence, in the quest for a less morbid form of treatment, multimodality approaches with various combinations of surgery, chemotherapy, and radiation therapy have been suggested for advanced vulvar cancers. Due to the low incidence of the disease, the level of evidence for the success of these treatment modalities is poor. Mrs. X, a 54-year-old female, P2L2 A0 presented at Apollo hospitals, Ahmedabad with a giant vulvar tumor of about 8x7 cm in size arising from anterior half of vulva involving clitoris and both labia minora. The vulval growth was initially small and had attained present size in last 15 days. She had complaints of postmenopausal bleeding per vaginum for 8 days, foul smelling discharge and itching vulva on and off for 1 month. Biopsy revealed moderate to well differentiated squamous cell carcinoma (SCC). MRI pelvis with contrast found suspicious lymph node in bilateral iliac vessel region and bilateral inguinal region. She underwent radical vulvectomy with bilateral inguinal lymph node dissection, and bilateral pelvic lymph node dissection. Early diagnosis, timely intervention and prompt surgical management could save the patient’s life. Histopathological report showed well differentiated SCC of vulva with no lymphnodes involvement. Depth of tumor was 12 mm and there was no lymphovascular and perineural invasion. All surgical margins and base of growth were free of tumor. According to TNM stabilization patient had SCC vulva stage IB (T1bN0M0). This patient was disease free after 18 months of follow-up. Vulvar cancer incidence is significantly high in post-menopausal and multiparous women. The most important prognostic factors are tumor stage and lymph node status. Oncological resection should be equated with functional outcome. The multidisciplinary team approach should be sought for this rare gynecological malignancy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Radical vulvectomy for a rare case of squamous cell carcinoma vulva: a case report

Nahar

2021

Int J Reprod Contracept Obstet Gynecol

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“…Adjuvant radiotherapy is recommended in high risk cases with tumour size over 4 cm, lymphovascular invasion, lymph node invasion and close or positive surgical margins (11). Radiotherapy of the inguinal region is also indicated in patients that have only an invaded lymph node (1).…”

Section: Discussionmentioning

confidence: 99%

A rare case of vulvar squamous cell carcinoma; case presentation

Cozma¹,

Răducu²,

Avino³

et al. 2018

J Clin Invest Surg.

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Objectives. Vulvar cancer is a rare gynecological malignancy, with an incidence of 1.5 per 100 000 women/year. The most common vulvar cancer is developed in squamous cells, the most encountered type of skin cells. Case report. We report a case of a 72-year-old female admitted in the Department of Plastic Surgery of Emergency Clinical Hospital "Prof. Dr. Agrippa Ionescu" with a 5/4.2 cm painful ulcerated tumoral mass located in the vulvar area. The lesion slowly increased in size over the past 12 months. The tumour was surgically removed with oncological safety margins and sent for histopathological evaluation. The histopathological examination revealed an ulcerated squamous carcinoma with lymphovascular and perineural invasion, but with negative margins. Postoperative results were favorable, and no local or general complications were observed. Conclusion. We highlight this case due to its unusual presentation in the clitoral area. Moreover, considering the potential for recurrence we point out the importance of the radical vulvectomy with regional lymphadenectomy and histopathological examination, in order to put a precise diagnosis and ensure the best possible treatment for the patient.

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Gynecologic Cancers

Albuquerque¹,

Leung²,

Mayr³

2016

Medical Radiology

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ACR Appropriateness Criteria® Management of Locoregionally Advanced Squamous Cell Carcinoma of the Vulva

Abstract: In combining available medical literature and expert opinion, this manuscript may serve as an aid for other practitioners in the appropriate management of patients with LRAVC.

Cited by 21 publications

References 38 publications

Radical vulvectomy for a rare case of squamous cell carcinoma vulva: a case report

Radical vulvectomy for a rare case of squamous cell carcinoma vulva: a case report

A rare case of vulvar squamous cell carcinoma; case presentation

Gynecologic Cancers

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