Adenoid Cystic Carcinoma of Vulva-11 Years' Single-Institution Experience.

INTRODUCTION: Adenoid cystic carcinoma of vulva (ACC-vulva) is an extremely rare entity with <100 cases reported in the literature so far. OBJECTIVE: To study the clinical profile and outcome of ACC-vulva treated at a tertiary cancer care centre in South India. METHODS: This is a retrospective, record-based study of histopathologically confirmed cases of ACC-vulva treated at our centre from January 2005 to March 2016. RESULTS: Only four patients were diagnosed with ACC-vulva during the 11-year period under study. The longest duration of follow-up was 129 months. The age at diagnosis ranged from 32 to 43 years, with a median of 40 years. All patients were married, parous and premenopausal and presented with a painless unilateral vulval swelling. All patients had involvement of the Bartholin's gland site with normal overlying skin. In all patients, wide excision was performed. Unilateral inguinal node dissection was done in one case. Perineural infiltration was documented in two cases, while positive excision margins were present in three cases. None of the patients had any lymph node involvement at diagnosis or during follow-up. Two patients had recurrence of disease. The disease-free interval was 23 months for one patient and 118 months for the other. In both, local (vulval) and distant (multiple lung) metastases were detected simultaneously. CONCLUSION: Adenoid cystic carcinoma of vulva is an extremely rare, slowly progressing neoplasm mostly involving the Bartholin's gland. The usual treatment includes wide excision and adjuvant radiotherapy (if required). There may be late local and distant recurrence.

Squamous cell carcinoma in untreated psoriasis: a case report.

Skin cancer developing after treatment for psoriasis is seen more often than expected, however, there has been no report of cutaneous squamous cell carcinoma developing in a case of untreated psoriasis. Here, a case has been reported where an untreated psoriasis lesion progressed on to develop squamous cell carcinoma, with a brief review of literature.

Patterns of cervical metastasis from carcinoma of the oral tongue.

BACKGROUND: Cancer of the oral tongue is the second most common cancer among males in various parts of India. Despite advances in diagnosis and treatment the failure rates in cancer of the oral tongue are high and survival poor. Majority of these failures occur in untreated neck. METHOD: A retrospective review of the records of 75 patients undergoing surgery for the treatment of squamous cell carcinoma of the oral tongue was carried out to ascertain the pattern of metastasis in the neck and to evaluate the sensitivity of clinical examination in predicting nodal spread. RESULTS: All the patients underwent primary surgery. Cervical lymph node metastasis was found in 35.6% of T1 and T2 tumours and 62.35% of T3 and T4 tumours. Sensitivity of clinical examination was found to be 54.5% and specificity of 61.9%. Level II was the most commonly involved (63.6%). Isolated level IV involvement was never found in clinically negative neck. Tumour stage and node status were found to have a significant impact on disease free survival in both univariate and multivariate analysis. CONCLUSIONS: As the sensitivity and specificity of the clinical examination is low we suggest that methods like ultrasound or CT Scan of the neck should be regularly employed to improve the sensitivity and specificity of the examination. Furthermore as isolated level IV involvement is never found in our series, we suggest that a prophylactic supraomohyoid neck dissection should be carried out in all patients with a clinically node negative neck with cancer of oral tongue, to achieve a better disease free survival.