Article Text

Download PDFPDF
Sentinel lymph node identification in a primary ductal carcinoma arising in the vulva
  1. J. M. Martinez-Palones*,
  2. A. Perez-Benavente*,
  3. B. Diaz-Feijoo*,
  4. A. Gil-Moreno*,
  5. I. Roca,
  6. A. García-Jimenez,
  7. I. Aguilar-Martinez* and
  8. J. Xercavins*
  1. * Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-infantil Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain
  2. Service of Nuclear Medicine, Hospital General Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain
  3. Department of Pathology, Hospital General Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain
  1. Address correspondence and reprint requests to: Jose M. Martinez-Palones, MD, Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-infantil Vall d'Hebron, Passeig Vall d'Hebron 119–129, E-08035 Barcelona, Spain. Email: jmmartin{at}vhebron.net

Abstract

Primary or metastasic breast-like carcinoma of the vulva is a rare event. Because of the similarity with breast ductal carcinoma, we think that the same principles used for treatment of orthotopic breast cancer can be applied, as well as the use of sentinel lymph node technique, which is widely accepted in the management of early-stage breast cancer. We report a 49-old-year postmenopausal woman who was referred to our institution after small biopsy of a 3.5- × 3-cm right vulvar tumor. Histopathologically, infiltration of the vulvar dermis by a ductal carcinoma of mammary gland type was reported. At operation, the sentinel node technique revealed two sentinel nodes in the right inguinal area. Although these nodes proved negative for malignancy, the patient underwent wide local excision of tumor and complete ipsilateral inguinofemoral lymphadenectomy. The remaining excised nodes were negative. Surgical specimen proved estrogen- and progesterone-positive receptors, the reason for which the patient received tamoxifen adjuvant therapy. This report represents the first case in the world literature of primary breast carcinoma arising in the vulva in which sentinel lymph node identification has been possible. Because of the rarity of this condition, the pathologic similarity of this tumor along with currently accepted guidelines for the management of breast cancer supports the possibility of local excision and sentinel lymph node identification as a possible alternative to inguinofemoral lymphadenectomy

  • ductal carcinoma vulva
  • estrogen receptor
  • sentinel lymph node

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.