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False-negative sentinel node in patients with vulvar cancer: A case study
  1. F. RASPAGLIESI*,
  2. A. DITTO*,
  3. R. FONTANELLI*,
  4. M. MACCAURO,
  5. M.L. CARCANGIU,
  6. F. PARAZZINI§ and
  7. E. BOMBARDIERI
  1. * Department of Gynaecologic Oncology, Istituto Nazionale Tumori, Italy
  2. †Department of Nuclear Medicine, Istituto Nazionale Tumori, Italy
  3. ‡Department of Human Pathology, Istituto Nazionale Tumori, Italy
  4. ***Department of Obstetrics Gynecology, Università degli studi di Milano, Clinica Mangiagalli, Milan, Italy
  1. Correspondence should be addressed to: Francesco Raspagliesi, M.D., Istituto Nazionale Tumori, via Venezian 1, 20133 Milan, Italy. Email: dittotony{at}hotmail.com

Abstract

Evidence from recent studies indicates that the technique of sentinel node biopsy might be a useful solution for detecting lymph node status for primary vulvar cancer without having to perform radical inguinal lymphadenectomy. The patient in this report underwent sentinel node biopsy, then bilateral inguino-femoral node dissection, and, lastly, radical vulvectomy. The histologic analysis showed a well differentiated squamous cell carcinoma with metastases in one right inguinal node and one left inguinal node and a false-negative right sentinel node. Technically the biopsy of groin sentinel nodes should be quite easy to perform. The use of preoperative lymphoscintigraphy and the intraoperative use of the gamma probe combined with blue dye helps considerably in identifying lymphatic drainage and the sentinel node for vulvar cancer. Further results are needed to confirm the value of sentinel node dissection in the treatment of early stage vulvar cancer.

  • lymphadenectomy
  • lymphatic mapping
  • lymphoscintigraphy
  • sentinel lymph node biopsy
  • vulvar cancer

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