ABSTRACT
Abstract Introduction In the present study, we report a case of primary adenoid cystic carcinoma (ACC) of the Bartholin gland with high-grade transformation (HGT). Adenoid cystic carcinoma of the Bartholin gland is a rare tumor and HGT has only been reported in head and neck tumors. Case Report A 77-year-old woman with a non-ulcerated vulvar lesion on the topography of the right Bartholin gland. The patient was submitted to tumor resection followed by V-Y island flap and adjuvant radiotherapy. The histopathological examination revealed primary ACC of the Bartholin gland, with areas of HGT and extensive perineural invasion. The immunohistochemical study with p53 showed a diffuse and strong positive reaction in areas with HGT. After 24 months of follow-up, the patient presented distant metastases and died, despite having undergone to chemotherapy. Conclusion As far as we know, this case is the first description in the literature of HGT in ACC of the Bartholin gland, and HGT appears to be associated with tumor aggressiveness.
Resumo Introdução Este estudo relata o caso de um carcinoma adenoide cístico (CAC) de glândula de Bartholin com transformação de alto grau. O CAC de glândula de Bartholin é um tumor raro, e sua transformação de alto grau é relatada somente em tumores de cabeça e pescoço. Relato de caso Paciente de 77 anos de idade, do sexo feminino, com lesão vulvar não ulcerada na topografia da glândula de Bartholin direita. A paciente foi submetida a ressecção do tumor e realização de retalho em V-Y, seguidas de radioterapia adjuvante. O exame histopatológico revelou CAC primário de glândula de Bartholin, com áreas de transformação de alto grau e invasão perineural. O estudo imunohistoquímico com p53 mostrou reação positiva difusa e intensa em áreas com transformação de alto grau. Após 24 meses de seguimento, a paciente apresentou metástases à distância e faleceu, apesar de ter sido submetida a quimioterapia. Conclusão Pelo que sabemos, este caso é a primeira descrição na literatura de transformação de alto grau em CAC de glândula de Bartholin, e a transformação de alto grau parece estar associada à agressividade do tumor.
Subject(s)
Humans , Female , Aged , Bartholin's Glands , Vulvar Neoplasms , Carcinoma, Adenoid Cystic/therapy , Radiotherapy, AdjuvantABSTRACT
Around 2-7% of all vulvar cancers are represented by primary carcinomas of Bartholin gland. Here we are presenting such a rare case of carcinoma of Bartholin gland. 45/F P2L2 presented in our OPD with non-healing lesion in vulva for 2 months. She had history of Bartholin’s cyst excision (elsewhere), 2 months back (the exact time since when she is having the non-healing lesion in vulva). Diagnostic biopsy revealed it to be vulval squamous cell carcinoma. She was given two cycles of Neo adjuvant chemotherapy (Inj. Paclitaxel and Carboplatin). In view of better response to the treatment patient was planned for surgery. Patient underwent wide local excision with bilateral inguinofemoral lymphadenectomy. Although the majority of vulvar lesions are benign, especially in women younger than 50 years of age, any solid mass should be carefully evaluated for malignancy. Preferably biopsy of Bartholin gland should be considered if the patient is more than 40 years of age and should be mandatory in a menopausal woman.
ABSTRACT
The adenoid cystic carcinoma (ACC) of the Bartholin's gland (BG) is one of the most uncommon variant of vulvar malignancies representing only 1015% of cases. The main differential diagnosis is the BG cyst. Risk factors to the development of ACCBG are still unclear. The symptoms are usually non-specific and may include local inflammation, pain, local itching, burning sensations, bleeding, pruritus and or dyspareunia. There is currently no consensus regarding the optimal surgical treatment and the question whether to do or not a systematic inguinal femoral lymph node dissection is still controversial. Guidelines for postoperative chemotherapy or chemoradiotherapy are not established, despite the relative frequency of microscopically positive surgical resection margin. Adjuvant radiation therapy seems to lower the incidence of local recurrence in patients with positive resection margins, based on retrospective studies and case reports. Chemotherapy as adjuvant treatment is still under evaluation
Subject(s)
Humans , Female , Adult , Radiotherapy , General Surgery , Bartholin's Glands , Carcinoma, Adenoid Cystic , Drug Therapy , Margins of Excision , Risk FactorsABSTRACT
Abstract Genital leiomyomas are rare tumors that can often be misdiagnosed as Bartholin cyst. We report a case of a 32-year-old patient who had a cystic nodulation in the left labium majus that was suggestive of Bartholin cyst. A resection surgery was performed, and the definitive histopathology diagnosis was vulvar leiomyoma. The macroscopic features of cystic lesions difficult the differential diagnosis between leiomyoma and Bartholin cyst; therefore, a histopathologic examination is often recommended.
Resumo Os leiomiomas genitais são tumores raros, e frequentemente são diagnosticados como cisto de Bartholin. Relatamos o caso de uma paciente de 32 anos em que ocorreu nodulação cística no grande lábio esquerdo sugestiva de cisto de Bartholin. Uma cirurgia de ressecção foi realizada, e o diagnóstico histopatológico definitivo foi leiomioma vulvar. As características macroscópicas das lesões císticas dificultam o diagnóstico diferencial entre o leiomioma e o cisto de Bartholin, demodo que o exame histopatológico é frequentemente recomendado.
Subject(s)
Humans , Female , Adolescent , Bartholin's Glands , Vulvar Diseases/pathology , Vulvar Neoplasms/pathology , Cysts/pathology , Leiomyoma/pathology , Diagnosis, DifferentialABSTRACT
PURPOSE: To evaluate the effectiveness, recurrence rate, and complications of carbon-dioxide laser vaporization in the treatment of Bartholin's gland cysts. METHODS: A retrospective study including 127 patients with symptomatic Bartholin' gland cysts submitted to carbon-dioxide laser vaporization at our institution from January 2005 to June 2011. Patients with Bartholin's gland abscesses and those suspected of having neoplasia were excluded. All procedures were performed in an outpatient setting under local anaesthesia. Clinical records were reviewed for demographic characteristics, anatomic parameters, intraoperative and postoperative complications, and follow-up data. Data were stored and analyzed in Microsoft Excel® 2007 software. A descriptive statistical analysis was performed, and its results were expressed as frequency (percentage) or mean±standard deviation. Complication, recurrence, and cure rates were calculated. RESULTS: The mean age of the patients was 37.3±9.5 years-old (range from 18 to 61 years-old). Seventy percent (n=85) of them were multiparous. The most common symptom was pain and 47.2% (n=60) of patients had a history of previous medical and/or surgical treatment for Bartholin's gland abscesses. Mean cyst size was 2.7±0.9 cm. There were three (2.4%) cases of minor intraoperative bleeding. Overall, there were 17 (13.4%) recurrences within a mean of 14.6 months (range from 1 to 56 months): ten Bartholin's gland abscesses and seven recurrent cysts requiring reintervention. The cure rate after single laser treatment was 86.6%. Among the five patients with recurrent disease that had a second laser procedure, the cure rate was 100%. CONCLUSIONS: At this institution, carbon-dioxide laser vaporization seems to be a safe and effective procedure for the treatment of Bartholin's gland cysts.
OBJETIVO: Avaliar a eficácia, a taxa de recorrência e as complicações da vaporização laser com CO2 no tratamento dos cistos da glândula de Bartholin. MÉTODOS: Estudo retrospectivo com 127 pacientes que apresentavam cistos sintomáticos da glândula de Bartholin submetidas à vaporização laser CO2 na nossa instituição de janeiro de 2005 a junho de 2011. Foram excluídas todas as pacientes com abcessos da glândula de Bartholin ou com suspeita de câncer. Todos os procedimentos foram realizados em regime ambulatorial, sob anestesia local. A coleta dos dados foi feita com base na consulta do processo clínico, tendo-se procedido à análise das características demográficas, dos parâmetros anatômicos, das complicações intra e pós-operatórias e dos dados de acompanhamento. Os dados foram armazenados e analisados no software Microsoft Excel® 2007, e os resultados foram apresentados como frequência (porcentagem) ou média±desvio padrão. As taxas de complicações, recorrência e cura foram calculadas. RESULTADOS: A idade média das pacientes foi de 37,3±9,5 anos (variando entre 18 e 61 anos). Setenta por cento (n=85) delas eram multíparas. A queixa mais frequente foi dor e 47,2% (n=60) das pacientes tinham antecedentes de tratamento médico e/ou cirúrgico por abcesso da glândula de Bartholin. A dimensão média dos cistos foi de 2,7±0,9 cm. Foram verificados três (2,4%) casos de hemorragia intraoperatória ligeira e 17 (13,4%) recorrências durante um período médio de 14,6 meses (variando entre 1 e 56 meses): dez abscessos da glândula de Bartholin e sete cistos recorrentes, que precisavam de uma nova intervenção cirúrgica. A taxa de cura após um único tratamento à laser foi de 86,6%. Dentre as cinco pacientes com doença recorrente que foram submetidas a um segundo procedimento com laser, a taxa de cura foi de 100%. CONCLUSÕES: Na presente instituição, a vaporização laser com CO2 parece ser uma opção terapêutica segura e eficaz no tratamento dos cistos da glândula de Bartholin.
Subject(s)
Adolescent , Adult , Female , Humans , Middle Aged , Young Adult , Bartholin's Glands , Cysts/surgery , Laser Therapy , Lasers, Gas/therapeutic use , Vulvar Diseases/surgery , Laser Therapy/adverse effects , Lasers, Gas/adverse effects , Recurrence , Retrospective StudiesABSTRACT
The Bartholin's gland (BG) may develop several tumoral lesions such as BG duct cysts, carcinomas, hyperplasias, and adenomas. BG nodular hyperplasias (NHs) are uncommon, and few cases have been reported in the literature. Specific criteria for the distinction between adenomas and hyperplasias have been recently established. Several questions on possible etiologies and appropriate medical approach still remain. Therefore, this work comprises three case reports of NH and an extensive literature review.
A glândula de Bartholin (GB) pode ser sede de várias lesões tumorais, como cistos do ducto da GB, carcinomas, hiperplasias e adenomas. A hiperplasia nodular (HN) da GB é uma lesão rara e poucos casos foram relatados na literatura. Recentemente, critérios específicos estabeleceram a diferenciação entre adenomas e hiperplasias. Muitas dúvidas ainda permanecem sobre as possíveis etiologias e a conduta ideal ante essa lesão. Diante disso, o presente trabalho realizou o relato de três casos de HN e ampla revisão sobre o tema.
Subject(s)
Humans , Female , Adult , Adenoma , Diagnosis, Differential , Bartholin's Glands/pathology , Hyperplasia/diagnosisABSTRACT
Introducción: en el presente artículo se expone el caso de una paciente que tuvo un quiste gigante de la glándula de Bartolino, el cual alcanzó un diámetro de 10 cm. La paciente presentó algunas dificultades diagnósticas y terapéuticas por lo que fue necesaria la escisión de la glándula y la posterior reconstrucción de la vulva. El diagnóstico definitivo fue establecido por anatomía patológica. El caso se presenta con el objetivo de realizar una revisión de la literatura respecto al tratamiento. Materiales y métodos: se realizó una búsqueda de la literatura relacionada con el tema en las bases de datos electrónicas PubMed, SciELO, ScienceDirect y MD Consult, utilizando las palabras clave: "glándulas de Bartolino", "quistes" y "marsupialización". Además, se revisaron referencias de libros de textos. Conclusiones: la urgencia en el tratamiento depende de los síntomas de la paciente. Un quiste asintomático podría no requerir tratamiento. Sin embargo, la no mejoría dentro de las primeras 72 horas o la evolución hacia una forma de absceso requerirá un tratamiento quirúrgico de emergencia. Se ha descrito una amplia variedad de tratamientos que incluyen una serie de procedimientos quirúrgicos tales como: 1) incisión simple y drenaje, 2) fistulización o marsupialización, 3) colocación de un catéter de Word, 4) escleroterapia con alcohol, 5) aplicación de nitrato de plata y 6) ablación del quiste utilizando dióxido de carbono (CO2 ) con láser.
Introduction: the case of a patient who had a giant Bartholin gland cyst is presented; it reached 10 cm diameter, presenting some diagnostic and therapeutic difficulties, requiring the excision of the gland and later reconstruction of the vulva. Definitive diagnosis was established by pathological anatomy. The case is presented as it led to a review of the pertinent literature regarding the relevant treatment. Materials and methods: a search was made of the pertinent literature in PubMed, SciELO, ScienceDirect and MD Consult databases, using the key words "Bartholin glands", "cysts", "marsupialization". Pertinent reference books were also reviewed. Conclusions: the urgency of treatment depends on a particular patient's treatment. An asymptomatic cyst may not require treatment; however, if there is no improvement within the first 72 hours or it evolves towards an abscess, then it will require emergency surgical treatment. A broad variety of treatments has been described which includes a series of surgical procedures, which include: simple incision and drainage, fistulization or marsupialization, placing a Word catheter, sclerotherapy with alcohol, applying silver nitrate and cyst ablation using carbon dioxide (CO2) laser.
Subject(s)
Humans , Female , Adult , Bartholin's Glands , CystsABSTRACT
Sparganosis is a parasitic infection caused by the plerocercoid larvae of diphyllobothroid tapeworms belonging to the genus Spirometra, as first described by Manson in 1882. The infection is transmitted by ingestion of contaminated water, frogs, and snakes, and contact between a second intermediate host and an open wound or mucus membranes. Humans are accidental hosts in the life cycle, but dogs, cats, and other mammals are definitive hosts. Once a human becomes infected, the plerocercoid larvae migrate to a subcutaneous location, where they typically develop into a painful nodule. We misdiagnosed vulva sparganosis as a Bartholin's gland abscess. The patient was a green consumer, so she may have been infected by consuming health foods. Sparganosis should be considered as a cause of soft tissue masses especially among patients who have ingested health foods.
Subject(s)
Animals , Cats , Dogs , Humans , Abscess , Cestoda , Eating , Food, Organic , Life Cycle Stages , Mammals , Membranes , Mucus , Snakes , Sparganosis , Sparganum , Spirometra , VulvaABSTRACT
A 40-year-old woman underwent surgery to remove tender bilateral vulvar masses. The masses were gray/brown, well circumscribed, non-encapsulated, and were composed of an increased number of ducts and acini with a normal lobular architecture and a duct-acinar relationship. This appearance was consistent with Bartholin's gland hyperplasia (BGH). Bilateral Bartholin's gland cysts were also associated with BGH. Benign tumors and tumor-like conditions of Bartholin's gland are uncommon, and only a few cases of BGH have been reported in the literature. Hyperplasia is a rare etiology for an enlarged Bartholin's gland, and must be distinguished histologically from adenoma.
Subject(s)
Female , Humans , CystsABSTRACT
Adenoid cystic carcinoma (ACC) of the Bartholin's gland is a rare malignancy of the female genital tract and there have been 62 cases of ACC of the Bartholin's gland in the literature. We report two cases of ACC of the Bartholin's. There is no consensus on optimal treatment of ACC of the Bartholin's gland. Most commonly, wide local excision and radical vulvectomy with or without lymph node dissection, are performed. More long-term follow up is recommended to evaluate optimal primary treatment and roles of radiotherapy and chemotherapy because ACC of the Bartholin's gland recur and metastasize long after primary treatment.
Subject(s)
Female , Humans , Adenoids , Carcinoma, Adenoid Cystic , Consensus , Drug Therapy , Follow-Up Studies , Lymph Node Excision , RadiotherapyABSTRACT
Carcinomas of Bartholin's gland are rare tumor that account for less than 0.001% of all gynecological malignancy, and account for 2-7% of vulvar malignancy. The treatment of Bartholin's gland carcinoma is not established yet. So it should be individualized to the patient by the resectability and the status of resection margin involvement. We experienced a case of squamous cell carcinoma of the Bartholin's gland treated by wide local excision and post-operative radiation therapy. We report this malignancy with a brief review of literature.
Subject(s)
Humans , Carcinoma, Squamous CellABSTRACT
We report a case of squamous cell carcinoma of Bartholin's gland for the first time in Korea. The patient had diagnosed unexpectedly by an incidental Rt. Bartholin's cystectomy at Chunchon Sacred Heart Hospital. She was transferred to Asan Medical Center and performed Rt. hemivulvectomy with ipsilateral inguinal-femoral lymph node dissection for staging. She was FIGO stage II (T2N0M0) and has been followed up for 9 months without any evidence of recurrence. Squamous cell carcinoma of Bartholin's gland is very rare among the female genital malignancies. The treatment of this malignancy is not established yet. So it should be individualized to the patient by the resectability and the status of resection margin involvement.
Subject(s)
Female , Humans , Carcinoma, Squamous Cell , Cystectomy , Heart , Korea , Lymph Node Excision , RecurrenceABSTRACT
We report two cases of adenoid cystic carcinoma of Bartholin's gland. One of these patients had positive margin on operation and is scheduled for adjuvant radiotherapy. The other was first diagnosed 13 years ago and presented with her second recurrence without distant metastasis. Adenoid cystic carcinoma of the Bartholin's gland is a rare tumor of the vulva. When diagnosed, the treatment should be individualized to the patient. When the surgical margin is found to be positive, adjuvant radiotherapy seems to be beneficial.
Subject(s)
Humans , Adenoids , Carcinoma, Adenoid Cystic , Neoplasm Metastasis , Radiotherapy, Adjuvant , Recurrence , VulvaABSTRACT
We report two cases of adenoid cystic carcinoma of Bartholin's gland. One of these patients had positive margin on operation and is scheduled for adjuvant radiotherapy. The other was first diagnosed 13 years ago and presented with her second recurrence without distant metastasis. Adenoid cystic carcinoma of the Bartholin's gland is a rare tumor of the vulva. When diagnosed, the treatment should be individualized to the patient. When the surgical margin is found to be positive, adjuvant radiotherapy seems to be beneficial.
Subject(s)
Humans , Adenoids , Carcinoma, Adenoid Cystic , Neoplasm Metastasis , Radiotherapy, Adjuvant , Recurrence , VulvaABSTRACT
Carcinomas of Bartholin's gland are rare tumors that account for less than 1% of all gynecological malignancies. Two major histological types, squamous cell carcinoma and adenocarcinoma, account for 80% to 90% of primary cases. The remainders are adenosquamous carcinoma, adenoid cystic carcinoma and so on. We experienced a case of squamous cell carcinoma of the Bartholin's gland managed by wide local excision and chemotherapy with cisplatin and 5-fluorouracil (5-FU). We present this case with a brief review of the literatures.
Subject(s)
Adenocarcinoma , Carcinoma, Adenoid Cystic , Carcinoma, Adenosquamous , Carcinoma, Squamous Cell , Cisplatin , Drug Therapy , FluorouracilABSTRACT
Adenoid cystic carcinoma is a rare disease of which incidence is 10-15 % of bartholins gland carcinoma. The clinical presentation is characterized by a vulval mass that existed for a prolonged period to the onset of symptoms, usually infection, pain, and burningsensation Histologically, this tumor is characterized by cribriform pattern cell growing and perineural invasion. The obtaining of clear surgical margins is the most important aspect of treatment. Here we report a case of adenoid cystic carcinoma of the Bartholins gland with a brief review of literature.
Subject(s)
Adenoids , Carcinoma, Adenoid Cystic , Incidence , Rare DiseasesABSTRACT
A patient with squamous carcinoma of Bartholin gland including transitional component is reported and the literature related to this disease is reviewed. Carcinoma of the Bartholin gland is rare, comprising less than 1% of female genital tract cancer. This report was summurized a clinical experience of a 53 year old women with Bartholin gland carcinoma, FIGO Stage II. Histologically, this tumor is characterized by poorly differentiated squamous cell carcioma, individually cellular keratinizationa and transitional component. This patient was treated by modified radical vulvectomy with ipsilateral lymph node dissection and neoadjuvant chemotherapy(4 courses) and followed by radiation therapy.
Subject(s)
Female , Humans , Middle Aged , Carcinoma, Squamous Cell , Cellular Structures , Lymph Node ExcisionABSTRACT
A patient with primary adenocarcinoma of Bartholin's gland is reported and the literatures relevant to this disease reviewed. Not only this disease is very rare but also primary carcinomas of Bartholin's gland are misdiagnosed as cysts or abscesses in half of the cases, leading to considerable delay in diagnosis. And so, It was wasted long time before definitive therapy. However, because of a different clinical behavior, cancer of the Bartholin's gland should be distinguished from other vulvar carcinomas. Histologically, squamous cell carcinoma and adenocarcinoma are the most common. Virtually all histologic types of Bartholin's gland carcinoma metastasize to lymph node, bone, lung and liver in distant sites. The authors data and a review of the literature support the concept that radical vulvectomy with or without bilateral inguina1-femoral lymphadenectomy is required. On the other hand, except primary radiation treatment for small or medium sized cancers, the results obtained by radiation therapy in carcinoma of the vulva including Bartholin's gland are generally discouraging. A role for postoperative adjuvant radiation therapy suggests because of high incidence of positive inguinal-femoral lymph nodes. In the near time, natural history and biological behavior of Bartholin's gland cancer must be disclosed in detail. And also optimal treatment modality and prognostic factors shall be determine.