ABSTRACT
Vulvar lymphatic leakage is a severe complication associated with gynecological cancer treatments. However, standard treatment strategies have not yet been determined. We encountered a rare case of a 76-year-old multiparous woman suffering from massive lymphatic fluid leakage from the entire vulva, and papules developed and were identified as lymphangiomas. A large amount of straw-colored discharge continued from all vulvar papules, which extended over the mons pubis. Nine years ago, the patient had undergone a radical hysterectomy with concurrent chemoradiation for uterine cervical cancer treatment. Her serum albumin level was 1.9 mg/dl, which was attributed to the loss of a large amount of lymph fluid due to leakage from the vulva. Her quality of life gradually decreased because of general fatigue and the need for frequent diaper exchanges every 2 h. The patient received a less-invasive treatment with cryotherapy using liquid nitrogen. She also received a multimodality treatment consisting of the intravenous administration of albumin, massage of the lower limbs and intensive rehabilitation. Cryotherapy was administered once a week for 3 months. Her discharge almost stopped and vulvar lymphangiomas decreased without any major complications. To the best of our knowledge, this is the first case report of massive lymphatic leakage complicated with vulvar lymphangiomas. Additionally, this case may represent the first successful treatment of vulva lymph leakage by cryotherapy without recurrence. Cryotherapy may have the potential to improve the quality of life as a less-invasive treatment for gynecological cancer survivors without serious complications.
Subject(s)
Cryotherapy , Hysterectomy , Lymphangioma/therapy , Quality of Life , Uterine Cervical Neoplasms/therapy , Vulvar Neoplasms/therapy , Aged , Chemoradiotherapy , Combined Modality Therapy , Female , Humans , Treatment OutcomeABSTRACT
⺠Mohs' paste is made of a mixture of zinc chloride paste. ⺠Recent reports show that hemostasis could be achieved in various kinds of cancer. ⺠Mohs' paste can save a patient's life from fatal genital bleeding.
ABSTRACT
BACKGROUND: Atypical genital bleeding due to gynecologic cancer not only impairs patients' quality of life (QOL), but also becomes a major causative factor of death. We report the clinical usefulness of Mohs' paste for genital bleeding from the uterine cervix or vaginal stump in patients with recurrent gynecologic cancer. METHOD AND RESULTS: Eight patients with gynecologic cancer were enrolled between January 2010 and March 2012. Mohs' paste was directly applied to the bleeding tumor. In patients with recurrent genital bleeding after the application of Mohs' paste, the technique was repeated. The effect of this procedure continued for 4 days to 1 year. The effect of Mohs' paste continued for 3 months or more in three patients. None of the eight patients have died of genital bleeding. CONCLUSIONS: The use of Mohs' paste is safe and convenient for massive genital bleeding from the uterine cervix or vaginal stump due to recurrent gynecologic cancer. However, our study does have some limitations including the small number of enrolled subjects and heterogeneous cancer types.
