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1.
Reprod Sci ; 31(2): 550-554, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37794197

RESUMO

The metastasis of a gynecological malignancy to the Bartholin gland is rare. We report the case of a 62-year-old patient who had undergone extensive treatment of metastatic ovarian cancer that involved the liver, spleen, and peritoneum. She presented with painful swelling of the left vulva. Clinical and sonographic examinations showed a solid tumor in loco typico of the Bartholin gland. Surgical excision was performed. The patient died 3 months after the diagnosis of this metastasis. We performed a systematic search of PubMed, which yielded 453 entries. We selected those with at least an abstract available in English that described metastatic lesions on the Bartholin gland (n = 5). The review showed that a variety of primary cancers (colorectal, medullary thyroid, breast cancer, and endometrial cancers) metastasize to this location. Some patients showed signs of visceral metastasis. Bartholin gland metastases appeared as initial and metachronous manifestations. Most patients were symptomatic, with painful swelling or abscess. Genetic alterations were mentioned in some cases. The main pathways of metastasis discussed were lymphatic, but the mechanism of such metastasis remains unclear. Surgical resection was the preferred treatment option. The literature review indicated that Bartholin gland metastasis of ovarian cancer is rare and associated with poor prognosis. Oncological reasons for vulvar pathologies should be taken into consideration in patients with metastases.


Assuntos
Glândulas Vestibulares Maiores , Neoplasias da Mama , Ginecologia , Neoplasias Ovarianas , Humanos , Feminino , Pessoa de Meia-Idade , Glândulas Vestibulares Maiores/patologia , Glândulas Vestibulares Maiores/cirurgia , Neoplasias Ovarianas/cirurgia , Neoplasias Ovarianas/patologia , Neoplasias da Mama/patologia
5.
BMC Infect Dis ; 23(1): 333, 2023 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-37198537

RESUMO

BACKGROUND: Sneathia amnii is a conditional pathogen of the female genital tract that is involved in bacterial vaginosis and poor reproductive and perinatal outcomes. Few studies have reported subcutaneous cysts following invasive infection caused by S amnii. CASE PRESENTATION: Here we report the case of a 27-year-old woman who presented with Bartholin's gland cyst due to S amnii infection, and was successfully treated with surgical neostomy and antibiotic agents. The isolate was gram-negative, bacillary, anaerobic, and was identified by polymerase chain reaction (PCR) amplification of the 16 S rRNA. CONCLUSIONS: S amni is an important but underappreciated pathogen that needs further investigation. This report describes the microbial and pathogenic characteristics of S amnii and is expected to provide a valuable reference in obstetric and gynecologic clinical practice.


Assuntos
Glândulas Vestibulares Maiores , Cistos , Feminino , Humanos , Adulto , Glândulas Vestibulares Maiores/microbiologia , Glândulas Vestibulares Maiores/patologia , Glândulas Vestibulares Maiores/cirurgia , Antibacterianos/uso terapêutico , Fusobactérias , Cistos/diagnóstico
6.
Am J Case Rep ; 24: e939402, 2023 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-37243328

RESUMO

BACKGROUND Leiomyosarcomas of the vulva (VLMS) are very rare among gynecological malignancies, with a lack of knowledge on clinical presentation, prognosis, and therapeutic management. CASE REPORT The database of the German Clinical Center of Competence for Genital Sarcomas and Mixed Tumors in Greifswald (DKSM) was reviewed between the years 2010 and 2020. A total of 8 cases of VLMS were retrieved and analyzed retrospectively. One exemplary case of VLMS was outlined in detail: A 45-year-old premenopausal woman presented with increasing vulvar swelling and discomfort. Given the suspicion of a Bartholin's gland abscess, the mass was excised. Final pathology revealed a solid tumor consistent with a moderately differentiated leiomyosarcoma of the vulva. A wide local excision was subsequently performed followed by adjuvant external beam radiation. The clinical features of these 8 cases of VLMS were compared to 26 cases of VLMS found in a review of the literature and to a total of 276 cases of uterine leiomyosarcoma (ULMS) from the same database (DKSM). CONCLUSIONS In addition to rapid growth, observed in both tumor entities, VLMS most commonly presented as Bartholin's gland abscess or cyst and ULMS as leiomyoma. In this cohort, the prognosis of VLMS was much better than that of ULMS, most probably due to the significantly smaller tumor size of VLMS at diagnosis. Further data and larger studies on VLMS are needed to calculate recurrence and survival rates more accurately and define the role of adjuvant radiotherapy.


Assuntos
Glândulas Vestibulares Maiores , Leiomiossarcoma , Neoplasias Vulvares , Feminino , Humanos , Pessoa de Meia-Idade , Leiomiossarcoma/patologia , Abscesso , Estudos Retrospectivos , Glândulas Vestibulares Maiores/patologia , Neoplasias Vulvares/patologia
7.
Int J Gynaecol Obstet ; 163(3): 744-746, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37221998

RESUMO

To our knowledge, this is the first reported case of synchronous ovarian and vulva (Bartholin gland) cancer. A postmenopausal woman presented with a complex multiloculated left adnexal mass and 2-cm right Bartholin gland mass. CA 125 was 59 IU/mL. Computed tomography of chest, abdomen, and pelvis showed a very large (32 × 13.5 × 22.5 cm) complex mass arising from the pelvis and extending to the level of the T12/L1 disk space. A right Bartholin mass with suspicious right inguinal nodes was seen. Midline laparotomy, total abdominal hysterectomy, bilateral salpingo-oophrectomy, infracolic omentectomy, pelvic peritoneal biopsies, and peritoneal washings were carried out. Wide local excision of the right Bartholin gland mass was carried out in the same setting. Histopathology came back as Stage 2B left ovarian clear-cell carcinoma and synchronous right Bartholin gland adenoid cystic carcinoma with lymphovascular invasion, incompletely excised, staged at least FIGO Stage 1B. Following local multidisciplinary team discussion and positron emission tomography scan review, the local committee agreed to start three cycles of adjuvant chemotherapy then proceed with Bartholin gland scar re-excision and bilateral groin lymph node dissection. After the three cycles, the groin lymph nodes came back as metastatic adenocarcinoma with overall morphologic and immunohistochemical features consistent with metastatic ovarian clear-cell carcinoma. Postoperative adjuvant chemotherapy was given. Initial follow-up period over 9 months was uneventful.


Assuntos
Adenocarcinoma de Células Claras , Glândulas Vestibulares Maiores , Neoplasias Ovarianas , Neoplasias Vulvares , Feminino , Humanos , Glândulas Vestibulares Maiores/cirurgia , Glândulas Vestibulares Maiores/patologia , Ovário , Histerectomia , Excisão de Linfonodo , Adenocarcinoma de Células Claras/patologia , Neoplasias Vulvares/patologia , Neoplasias Ovarianas/cirurgia , Neoplasias Ovarianas/patologia
8.
BMC Womens Health ; 23(1): 156, 2023 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-37013513

RESUMO

BACKGROUND: Adenoid cystic carcinoma (ACC) in Bartholin's gland is an uncommon malignant tumor. These tumors have a vague clinical feature, so they are diagnosed late and discovered at a high-level stage. Our case presented Three Recurrences and Three times Misdiagnosis of Adenoid Cystic Carcinoma (ACC). CASE PRESENTATION: We report a case of adenoid cystic carcinoma arising in Bartholin's gland of a 64-year-old female patient that appeared after three previous vulvar tumors were excised. The patient underwent bilateral radiotherapy which was performed on the perineum. CONCLUSION: ACC of the vulvar sweat glands is prone to misdiagnosis and delay in both diagnosis and treatment. As seen in our case, it was misdiagnosed three times as Chondroid Syringoma. Further studies need to be conducted to better understand the tumor prognosis, and its optimal treatment options.


Assuntos
Glândulas Vestibulares Maiores , Carcinoma Adenoide Cístico , Neoplasias Vulvares , Feminino , Humanos , Pessoa de Meia-Idade , Carcinoma Adenoide Cístico/diagnóstico , Carcinoma Adenoide Cístico/cirurgia , Carcinoma Adenoide Cístico/patologia , Vulva/patologia , Neoplasias Vulvares/diagnóstico , Neoplasias Vulvares/cirurgia , Prognóstico
9.
Cancer Radiother ; 27(4): 328-336, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36759241

RESUMO

Adenoid cystic carcinoma of the Bartholin's gland (ACCBG) is a rare, slowly but aggressive malignancy. We reported the case of a 31-year-old woman who was treated by local excision and then hemi-vulvectomy, with positive margins and perineural invasion. Radiation therapy (RT) was then performed delivering 45Gy in 25 fractions in bilateral inguinal lymph nodes and 64.8Gy in 36 fractions on the vulvar area. After 30 months, there was no local relapse (LR) but the patient presented a histologically documented lung recurrence. Genomic profiling of the tumor showed a MYB-NFIB fusion transcript and a somatic mutation of PLCG1. A treatment by Lenvatinib was started. We conducted a literature review of 100 published cases. Patients were mainly treated by radical vulvectomy (30%), hemi-vulvectomy (17%), wide or local excision (21% and 24%, respectively) or other. Forty-four percent of patients received postoperative RT, more frequently in case of positive margin (71.9% versus 29.5%). RT may reduce the risk of LR regardless of margin status, with 15.4% vs. 41.9% of LR with or without RT, respectively, in patients with negative margins, and 13% vs. 33.3% of LR with or without RT, respectively, in patients with positive margins. The risk of relapse of any type was 40.9% in patients who received adjuvant RT vs. 48.2% in patients who did not. Median time to relapse was 24 months (range 6-156 months). The most frequent metastatic sites were lung (76.7%) and bone (26.7%). Optimal treatment for ACCBG is still not clearly defined but pooling the data from published case report help us better understand this rare disease and help in the therapeutic decision.


Assuntos
Glândulas Vestibulares Maiores , Carcinoma Adenoide Cístico , Neoplasias Vulvares , Feminino , Humanos , Adulto , Carcinoma Adenoide Cístico/genética , Carcinoma Adenoide Cístico/terapia , Glândulas Vestibulares Maiores/patologia , Neoplasias Vulvares/genética , Neoplasias Vulvares/terapia , Genômica , Recidiva
10.
J Med Case Rep ; 17(1): 68, 2023 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-36782265

RESUMO

BACKGROUND: Vulvar leiomyoma is a rare soft tissue tumor, with only around 300 cases described in the literature. Owing to its low incidence of just 0.03% of all gynecological tumors, it often poses a great diagnostic challenge, especially in teenagers. We report this rare occurrence of vulvar leiomyoma in a teenage girl who was primarily left untreated due to cultural taboos and fear of loss of virginity. The main aim in presenting such rare case studies is to raise awareness and expand the diagnostic horizon of the surgeon for appropriate management. CASE PRESENTATION: We describe a case of a 15-year-old North Indian, sexually inactive unmarried girl, who presented with a history of painless swelling in the left labia majora for the last 1 year, which gradually increased in size. There was no associated pain or any other difficulty. Local examination revealed a 14 × 10 cm solid, unilateral nonpedunculated mass on the left labia majora with superficial vascularity. Differential diagnoses of sarcoma, lipoma, Bartholin cyst, and fibroid were kept in mind. Ultrasonography revealed a solid mass with superficial vascularity with normal internal genitalia. The mass was enucleated with an intact capsule under anesthesia. Histopathology confirmed it to be benign vulvar leiomyoma. The patient was discharged after 3 days in a satisfactory condition. CONCLUSION: Leiomyoma of the vulva is an exceptionally rare tumor and is seldom seen in teenagers. It is often misinterpreted as a Bartholin cyst and should be kept as one of the differential diagnosis in teenage girls presenting with unilateral vulvar swelling. Vulvar leiomyoma can be completely cured by surgical removal if diagnosed timely without compromising virginity, so should never be missed in adolescents.


Assuntos
Glândulas Vestibulares Maiores , Cistos , Leiomioma , Neoplasias de Tecidos Moles , Neoplasias Vulvares , Feminino , Adolescente , Humanos , Neoplasias Vulvares/diagnóstico , Neoplasias Vulvares/cirurgia , Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Vulva/cirurgia , Vulva/patologia , Cistos/patologia , Neoplasias de Tecidos Moles/patologia
12.
Medicine (Baltimore) ; 101(45): e31744, 2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36397326

RESUMO

RATIONALE: Adenoid cystic carcinoma (ACC) often occurs in the major and minor salivary glands and other sites containing secretory glands, while ACC of the Bartholin's gland (BG-ACC) in the vulva is rare and easily misdiagnosed. PATIENT CONCERNS: A 58-year-old female was referred to our hospital for further valuation of a mass occurring on the left side of her vulva. In the other hospital, the beginning of the period, local ultrasound showed a vulva mass, which was suspected to be a Bartholin's gland cyst. Mixed neoplasms were considered in some biopsies. When transferred to our hospital, virtuous tumors were considered by ultrasound and magnetic resonance imaging. Pathology initially considered benign hyperplastic active tumor or borderline tumor. DIAGNOSES: Histological, immunochemical, and molecular tests confirmed a diagnosis of BG-ACC, negative surgical margin, without lymphatic metastasis. INTERVENTIONS: Extended excision of the mass at left labia majora plus left inguinal lymph node dissection was performed. OUTCOMES: The patient received surgery therapy, no recurrence was observed during a 18-month follow-up period. LESSONS: Due to its lack of specific characteristics in clinical, ultrasound and imaging, it is easy to be misdiagnosed, Due to its rarity and nonspecific clinical, radiologic and ultrasonographic manifestations, BG-ACC can be easily misdiagnosed. And its pathomorphological features overlap with other benign and malignant tumors occurring at vulva, BG-ACC can be easily misdiagnosed, and diagnosis by puncture biopsy is extremely difficult. Use of paraffin sections to identify tumor growth characteristics, combined with immunohistochemical findings, is the key to the diagnosis of ACC. In rare sites, MYB gene split are helpful in making a definite diagnosis.


Assuntos
Glândulas Vestibulares Maiores , Carcinoma Adenoide Cístico , Neoplasias Vulvares , Humanos , Feminino , Pessoa de Meia-Idade , Glândulas Vestibulares Maiores/patologia , Carcinoma Adenoide Cístico/diagnóstico , Carcinoma Adenoide Cístico/cirurgia , Carcinoma Adenoide Cístico/patologia , Neoplasias Vulvares/diagnóstico , Neoplasias Vulvares/cirurgia , Neoplasias Vulvares/patologia , Vulva/patologia , Erros de Diagnóstico
13.
Eur J Obstet Gynecol Reprod Biol ; 276: 92-97, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35839715

RESUMO

OBJECTIVE: This study aim was to examine the success rate of simple needle aspiration for acute Bartholin's gland abscess and compare it to incision and drainage treatment. STUDY DESIGN: This was a non-randomised prospective study conducted at the academic Hospital of La Conception, Marseille, France. We included 202 women who presented with acute Bartholin's gland abscess between June 2013 and October 2017. The study cohort was subdivided into two treatment groups, simple needle aspiration (134 women) or incision and drainage (42 women), according to the women's preference. Success was considered as the absence of surgical treatment within one year of the initial treatment. RESULTS: The success rate was 68/134 (51% (95% CI: 42-59%)) in the simple needle aspiration group and 25/42 (60%) in the incision drainage group (RR: 0.85, 95% CI: 0.63-1.15, P = 0.3). Among 122/134 (91%) women who completed the satisfaction survey, 99/122 (81%) were satisfied with the simple needle aspiration. CONCLUSIONS: Simple needle aspiration can be offered as first-line treatment for acute Bartholin's gland abscess. Simple needle aspiration can be performed as an outpatient procedure without general anesthesia avoiding surgical treatment in half of the cases one-year post- simple needle aspiration.


Assuntos
Glândulas Vestibulares Maiores , Abscesso/cirurgia , Glândulas Vestibulares Maiores/cirurgia , Estudos de Coortes , Drenagem , Feminino , Humanos , Masculino , Estudos Prospectivos
14.
Am J Case Rep ; 23: e935707, 2022 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-35260546

RESUMO

BACKGROUND Adenoid cystic carcinomas of Bartholin's gland are rare among gynecological malignancies, accounting for 0.1% to 7% of vulvar carcinomas and 0.001% of all female genital tract malignancies. There are no specific guidelines regarding treatment recommendations; therefore, they are commonly treated like vulvar cancer. CASE REPORT We present the case of a 42-year-old premenopausal woman with an adenoid cystic carcinoma of Bartholin's gland diagnosed upon biopsy of a palpable, predominantly vaginally located mass causing foreign-body sensation, vaginal pain, and extreme dyspareunia. The adenoid cystic carcinoma of Bartholin's gland was treated by radical resection in an extensive interdisciplinary surgical approach including bilateral inguinal lymph node dissection, partial posterior colpectomy, amputation of the rectum, and creation of a descendostomy, as well as reconstruction of the vagina and defect coverage using flap plastic. CONCLUSIONS With the presentation of this case, we propose a possible therapeutic approach to adenoid cystic carcinomas of Bartholin's gland with emphasis on surgical management. Especially in young patients, we recommend primary radical surgery with the objective to obtain negative resection margins. However, additional data on the adenoid cystic carcinoma of Bartholin's gland is needed to better understand its biological behavior and thus optimize and standardize treatment. The role of systematic inguinal-femoral lymphadenectomy and adjuvant and neoadjuvant treatment modalities need further evaluation.


Assuntos
Glândulas Vestibulares Maiores , Carcinoma Adenoide Cístico , Neoplasias Vulvares , Adulto , Glândulas Vestibulares Maiores/patologia , Glândulas Vestibulares Maiores/cirurgia , Biópsia , Carcinoma Adenoide Cístico/patologia , Carcinoma Adenoide Cístico/cirurgia , Feminino , Humanos , Retalhos Cirúrgicos , Neoplasias Vulvares/patologia , Neoplasias Vulvares/cirurgia
17.
J Pediatr Adolesc Gynecol ; 35(3): 391-392, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34767968

RESUMO

BACKGROUND: Leiomyoma of the vulva is rare, accounting for only 0.03% of all gynecological tumors, and it is seldom seen in teenagers. CASE: We describe a case of vulvar leiomyoma in a 14-year-old girl who presented a 10 × 10 cm solid tumor in the right hemivulva without other complaints. SUMMARY AND CONCLUSION: Differential diagnosis includes Bartholin cysts, abscesses, fibromas, and other solid lesions. Although rare, vaginal leiomyoma must be remembered and included as a differential diagnosis for solid lesions in the vagina.


Assuntos
Glândulas Vestibulares Maiores , Leiomioma , Neoplasias Vaginais , Neoplasias Vulvares , Adolescente , Glândulas Vestibulares Maiores/patologia , Diagnóstico Diferencial , Feminino , Humanos , Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Neoplasias Vaginais/diagnóstico , Vulva/patologia , Neoplasias Vulvares/diagnóstico , Neoplasias Vulvares/patologia , Neoplasias Vulvares/cirurgia
18.
Int J Gynecol Pathol ; 41(1): 93-97, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33720081

RESUMO

Melanocytic pigmentation occurs in multiple sites in the lower female genital tract, but is rare within benign cysts of the vulva. We report 3 patients with multiloculated cystic lesions of the vulvar vestibule exhibiting prominent melanocytic pigmentation. The current cases differ from a previous report of melanosis in a Bartholin gland cyst in that the population of melanocytes occupies the acinar structures of the gland, rather than a squamous-lined surface. A similar cell population is demonstrated by immunoperoxidase methods in a fourth patient's nonpigmented gland, suggesting that melanin production may arise in a native, rather than metaplastic, cell population.


Assuntos
Melanose/diagnóstico , Doenças da Vulva/diagnóstico , Adolescente , Idoso , Glândulas Vestibulares Maiores/patologia , Cistos/patologia , Diagnóstico Diferencial , Feminino , Humanos , Técnicas Imunoenzimáticas , Melanócitos/patologia , Melanose/patologia , Pessoa de Meia-Idade , Doenças da Vulva/patologia
19.
Int J Surg Pathol ; 30(2): 167-169, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34142902

RESUMO

Nodular hyperplasia of the Bartholin's gland is an underreported and extremely rare entity that presents as a solid lesion potentially raising concern for malignancy clinically, most solid lesions at this location are carcinomas. They may also be mistaken for a Bartholin cyst clinically. Nodular hyperplasia is rarer than carcinoma of the Bartholin gland, and hence pathologists may not be familiar with this entity, making it a pitfall in pathologic as well as a clinical diagnosis. Here we report a case originally considered a Bartholin cyst, but raising intraoperative concern due to solid elements. Histological examination of the lesion revealed nodular hyperplasia of Bartholin's gland. Recognition of this entity is important, as it is something that may be encountered by the pathologist.


Assuntos
Glândulas Vestibulares Maiores , Carcinoma , Cistos , Neoplasias Vulvares , Glândulas Vestibulares Maiores/patologia , Carcinoma/patologia , Cistos/diagnóstico , Cistos/patologia , Cistos/cirurgia , Feminino , Humanos , Hiperplasia/patologia , Neoplasias Vulvares/diagnóstico
20.
Rev Bras Ginecol Obstet ; 43(12): 980-984, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34933392

RESUMO

INTRODUCTION: In the present study, we report a case of primary adenoid cystic carcinoma (ACC) of the Bartholin gland with high-grade transformation (HGT). Adenoid cystic carcinoma of the Bartholin gland is a rare tumor and HGT has only been reported in head and neck tumors. CASE REPORT: A 77-year-old woman with a non-ulcerated vulvar lesion on the topography of the right Bartholin gland. The patient was submitted to tumor resection followed by V-Y island flap and adjuvant radiotherapy. The histopathological examination revealed primary ACC of the Bartholin gland, with areas of HGT and extensive perineural invasion. The immunohistochemical study with p53 showed a diffuse and strong positive reaction in areas with HGT. After 24 months of follow-up, the patient presented distant metastases and died, despite having undergone to chemotherapy. CONCLUSION: As far as we know, this case is the first description in the literature of HGT in ACC of the Bartholin gland, and HGT appears to be associated with tumor aggressiveness.


INTRODUçãO: Este estudo relata o caso de um carcinoma adenoide cístico (CAC) de glândula de Bartholin com transformação de alto grau. O CAC de glândula de Bartholin é um tumor raro, e sua transformação de alto grau é relatada somente em tumores de cabeça e pescoço. RELATO DE CASO: Paciente de 77 anos de idade, do sexo feminino, com lesão vulvar não ulcerada na topografia da glândula de Bartholin direita. A paciente foi submetida a ressecção do tumor e realização de retalho em V-Y, seguidas de radioterapia adjuvante. O exame histopatológico revelou CAC primário de glândula de Bartholin, com áreas de transformação de alto grau e invasão perineural. O estudo imunohistoquímico com p53 mostrou reação positiva difusa e intensa em áreas com transformação de alto grau. Após 24 meses de seguimento, a paciente apresentou metástases à distância e faleceu, apesar de ter sido submetida a quimioterapia. CONCLUSãO: Pelo que sabemos, este caso é a primeira descrição na literatura de transformação de alto grau em CAC de glândula de Bartholin, e a transformação de alto grau parece estar associada à agressividade do tumor.


Assuntos
Glândulas Vestibulares Maiores , Carcinoma Adenoide Cístico , Neoplasias Vulvares , Idoso , Carcinoma Adenoide Cístico/terapia , Feminino , Humanos , Radioterapia Adjuvante
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