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Abstract
Introduction/Background Vulvar cancer is a rare disease, with only 50 new cases reported annually in Slovenia, predominantly affecting individuals over the age of 70.
Methodology This case report highlights two patients sharing a unique and rare pathology related to recurrent vulvar carcinoma. The authors adhered to Care guidelines, with both patients providing informed consent.
Results We present two cases of acute hemorrhage originating from the iliac and femoral arteries in patients with recurrent vulvar carcinoma. Initial presentations at our institution revealed both patients classified as FIGO stage IB upon primary surgical intervention, encompassing wide excision with negative margins and bilateral sentinel inguinal lymph node (ILN) biopsy. Following a multidisciplinary board evaluation, the decision was made to forgo adjuvant treatment. Recurrence, localized either to the vulva or involving both the vulva and ILN, became evident 38 months post-primary treatment in both cases. Subsequent secondary surgeries, complemented by adjuvant chemoradiotherapy (CTRT) incorporating cisplatin, were undertaken. In one of the patients surgery was not radical (non resectable ILN). Approximately six months post-CTRT, both patients exhibited disease progression marked by necrosis and abscess formation in ILN. Antibiotic treatment and drainage proved ineffectual. Malignant invasion of vessel walls precipitated hemorrhagic events, with patient A experiencing hemorrhage from the left iliac artery 55 months post-primary treatment, and patient B from the right iliac and femoral artery 54 months post-primary treatment (figure 1). Despite the successful ligation of all affected arteries, both patients succumbed to their conditions, 17 and 20 days post-surgery, respectively.
Conclusion Despite commendable advancements in vulvar cancer treatment, this series underscores the formidable and intricate complications associated with recurrent vulvar carcinoma, calling for continued exploration and therapeutic innovation in this challenging clinical domain.
Disclosures No conflicts of interest.
