China
Africa
Explore chapters and articles related to this topic
Vulvar and Vaginal Trauma and Bartholin Gland Disorders
Published in Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy, Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
Malak El Sabeh, Mostafa A. Borahay
Small cysts usually resolve on their own. In the case of large, symptomatic cysts or abscess formation, treatment is incision and drainage. Incision and drainage alone can often lead to recurrence, so a Word catheter is placed for 4 to 6 weeks until epithelialization of the cyst and tract. Alternatively, marsupialization is usually done for recurrent Bartholin cysts or abscesses where the entire cyst or abscess is incised. Other reported treatments include silver nitrate gland ablation, use of carbon dioxide laser to create an opening in the skin, alcohol sclerotherapy, and needle aspiration [32]. Antibiotics are not usually indicated, but in the case of recurrent Bartholin cyst abscesses, antibiotics with polymicrobial coverage are considered. They should also be given if the cultured organism was N gonorrhoeae, which is the case approximately 10% of the time. If the patient is older than 40 years, a biopsy should be performed to rule out Bartholin gland carcinoma.
EMQ Answers
Published in Justin C. Konje, Complete Revision Guide for MRCOG Part 2, 2019
I Radical excision with bilateral inguinal lymphadenectomyThis is a rare vulval cancer. Histologically, it is usually a squamous carcinoma or adenocarcinoma. The current evidence base is insufficient to suggest different management from squamous tumours. The lesions are often deep-seated or likely to be associated with metastatic disease. The close proximity to the anal sphincter may necessitate partial resection with reconstruction and this may necessitate a defunctioning temporary colostomy. Any perimenopausal or postmenopausal woman with a persisting Bartholin abscess or cyst should be suspected of having a possible carcinoma. Appropriate biopsies and histological review should be undertaken. In general, these cancers have a poorer prognosis than squamous cell carcinoma of the vulva and often multiple treatment modalities are required. There are no data regarding the use of selective lymphadenectomy in Bartholin gland carcinoma. These patients will require bilateral inguinofemoral lymphadenectomy (because of the proximity of the gland to the midline). (British Gynaecological Cancer Society and The Royal College of Obstetricians and Gynaecologists, London, 2014)
Vulvar Cancer
Published in Dongyou Liu, Tumors and Cancers, 2017
SCC is a predominating malignancy of the vulva, accounting for about 90% of vulvar neoplasms, whereas malignant melanoma (2%–9%), Bartholin gland carcinoma, adenocarcinoma, invasive Paget disease, basal cell carcinoma, verrucous carcinoma, and sarcoma are relatively uncommon [2].
An update on current pharmacotherapy for vulvar cancer
Published in Expert Opinion on Pharmacotherapy, 2023
Giorgio Bogani, Innocenza Palaia, Giorgia Perniola, Federica Tomao, Antonella Giancotti, Daniele Di Mascio, Giuseppe Capalbo, Ludovico Muzii, Pierluigi Benedetti Panici, Violante Di Donato
Different histologic cancer subtypes may arise in vulvar structures, the most common types included squamous cell carcinoma (75%), basal cell carcinoma (8%), and malignant melanoma (6%) [3,4]. Other rarer conditions are Bartholin gland carcinoma, extramammary Paget’s disease, and vulvar sarcoma [5,6]. Figure 1 shows a case of locally advanced tumor of the vulva. Tumor size, stromal invasion, the extension of surrounding peroneal structures, lymph node involvement, and the presence of metastasis are the most important factors influencing patients’ prognosis. On the basis of these factors, the International Federation of Obstetrics and Gynecologists (FIGO) staging system categorized vulvar cancer in four stages. The FIGO staging system categorizes vulvar cancer in stages I, II, III, and IV according to the extension of the disease [7]. Table 1 displays the revised 2021 FIGO staging system for vulvar cancer. Accumulating evidence suggests that infection from HPV and p53 abnormality are one of the most important prognostic factors. In fact, vulvar cancer might be classified as HPV-positive (HPV pos), HPV-negative and p53 wild type (HPV neg/p53 wt), and HPV-negative and abnormal expression of p53 (HPV neg/p53 abn) [8]. Figure 2 shows the main classification system for vulvar cancers, based on HPV infection and p53 expression. Other important biological variables included abnormalities of the expression of VEGF, HER2, and EGFR [8].
A review of vulvar carcinoma at Groote Schuur hospital for the period 2002 to 2012 with particular emphasis on HPV-related disease
Published in Southern African Journal of Gynaecological Oncology, 2020
Francisca E Loggenberg, Tracey S Adams
In South Africa, health services are divided into the public sector, which is government funded, and the private sector, which relies on payment from medical aid insurance schemes and patients who pay privately for services. Groote Schuur Hospital is a tertiary level Government-funded hospital servicing parts of the Western Cape. All women diagnosed with vulvar carcinoma who attended the multidisciplinary combined cancer clinic at Groote Schuur Hospital from 2002 to 2012 were included. A total of 139 women were in the database. Ten of the cases were excluded as it was not possible to retrieve their folders. Two cases were incorrectly entered into the database and two cases of Bartholin gland carcinoma were excluded. In total 125 patient folders were reviewed. Of these patients, 101 had evidence of HPV disease and further data were collected on these cases (see Figure 1).
Recurrence of Bartholin gland mucinous adenocarcinoma managed with posterior exenteration: a case report
Published in Journal of Obstetrics and Gynaecology, 2020
Nikolaos Blontzos, Christos Iavazzo, Eirini Giovannopoulou, Natasa Novkovic, Victoria Psomiadou, George Vorgias
Bartholin gland carcinoma (BGC) is a rare malignancy (<5% of vulvar cancers), first described by Klob (1964). It may arise either from the duct and the vestibular orifice of a Bartholin gland or from the gland itself, giving rise to multiple histologic subtypes: squamous cell carcinoma (30.7%), adenoid cystic carcinoma (29.6%), adenocarcinoma (25%) or less common subtypes (Donato et al. 2017). Although surgery remains the cornerstone of treatment, a multimodal approach is also supported concerning the management of both primary and recurrent disease.