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Medicine Nov 2022Adenoid 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... (Review)
Review
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.
Topics: Humans; Female; Middle Aged; Bartholin's Glands; Carcinoma, Adenoid Cystic; Vulvar Neoplasms; Vulva; Diagnostic Errors
PubMed: 36397326
DOI: 10.1097/MD.0000000000031744 -
Translational Cancer Research Jan 2023Bartholin's gland carcinoma (BGC) accounts for approximately 5% of all vulval malignancies-making it an extremely rare malignancy of the female genital tract. It...
BACKGROUND
Bartholin's gland carcinoma (BGC) accounts for approximately 5% of all vulval malignancies-making it an extremely rare malignancy of the female genital tract. It commonly manifests as a painless unilateral mass, near the introitus. BGC more commonly occurs in post-menopausal women. Unfortunately, over half of cases are associated with a missed or delayed diagnosis as it is often mistaken for a Bartholin's gland cyst or abscess. These tumours have a predilection for local and perineural invasion. Magnetic resonance imaging (MRI) is the imaging modality of choice for suspected Bartholin's tumour. Although no current guidance dedicated to the management of BGC exists, the majority of cases are treated by primary excision and bilateral groin node dissection (GND). Chemoradiotherapy has a role in both the adjuvant and palliative setting. BGC are typically associated with more advanced disease at presentation, higher rates of recurrence and poorer prognosis than other vulval cancer sub-types.
CASE DESCRIPTION
We share a case report of primary BGC-supported by high-quality radiological and surgical images; and further supplemented by a detailed review of current literature.
CONCLUSIONS
We aim to generate improved clinician awareness of this rare pathology, highlighting the need for vigilance to avoid misdiagnosis and subsequent treatment delay; as well as contribute towards generating consensus on the approach to management of this gynaecological malignancy.
PubMed: 36760371
DOI: 10.21037/tcr-22-612 -
Journal of Medical Case Reports Aug 2013Adenoid cystic carcinoma of Bartholin's gland is a very rare disease.
INTRODUCTION
Adenoid cystic carcinoma of Bartholin's gland is a very rare disease.
CASE PRESENTATION
A 48-year-old premenopausal woman of Caucasian origin was delivered adjuvant pelvic and inguinal radiotherapy after prior complete left Bartholin's gland tumor excision and inguinal lymph node dissection for adenoid cystic carcinoma of Bartholin's gland with one metastatic inguinal lymph node.Two years after primary treatment, she presented to the Emergency Room with acute headache, hypoacousia, decrease in visual acuity, and a decrease in right leg muscle strength. A cranial magnetic resonance imaging scan demonstrated three cystic brain lesions with associated perifocal edema. Chest and abdomen computed tomography scans and a magnetic resonance imaging scan of the pelvis did not find any metastatic or residual disease elsewhere. A physical examination found no local recurrence.Stereotactic brain biopsies with pathology examination revealed the presence of adenoid cystic carcinoma metastasis. She thus received 30Gy of brain radiotherapy but, three months later, the brain lesions did not decrease in size and left mid lobular lung lesions appeared on her chest computed tomography scan. A mid left lobe lung excision was undertaken followed by chemotherapy consisting of six cycles of cyclophosphamide, adriamycin and cisplatin. Five months after beginning chemotherapy, the brain disease progressed and our patient died.
CONCLUSION
Our case report shows the difficulty in managing brain and lung metastasis of Bartholin's gland adenoid cystic carcinoma as no consensus on the optimal treatment exists.
PubMed: 23945057
DOI: 10.1186/1752-1947-7-208 -
Archives of Pathology & Laboratory... May 2007Vulvar carcinoma is the fourth most frequently encountered malignancy of the female reproductive tract. Among vulvar neoplasms, 0.1% to 5% are of Bartholin gland origin.... (Review)
Review
Vulvar carcinoma is the fourth most frequently encountered malignancy of the female reproductive tract. Among vulvar neoplasms, 0.1% to 5% are of Bartholin gland origin. Primary adenoid cystic carcinoma of the Bartholin gland is very rare. To date, only about 60 cases have been reported in the world literature. Microscopic examination reveals a neoplasm of cribriform pattern composed of nests and columns of cells of bland appearance arranged concentrically around glandlike spaces filled with eosinophilic periodic acid-Schiff-positive diastase-resistant material. Immunohistochemically, the tumor cells express low-molecular-weight keratins, carcinoembryonic antigen, lysozyme, alpha1-antichymotrypsin, S100, and type IV collagen. Adenoid cystic carcinoma of the Bartholin gland is a slow-growing but locally very aggressive neoplasm with high capacity for recurrence. Perineural and lymphatic invasion is characteristic of this tumor and may explain its propensity for causing pain and recurrence. The treatment may range from simple local excision to radical vulvectomy, with or without partial to complete regional lymphadenectomy.
Topics: Bartholin's Glands; Carcinoma, Adenoid Cystic; Female; Humans; Vulvar Neoplasms
PubMed: 17488169
DOI: 10.5858/2007-131-796-ACCOTB -
Einstein (Sao Paulo, Brazil) 2016To describe the results of treatment with CO2 laser for Bartholin gland cysts.
OBJECTIVE
To describe the results of treatment with CO2 laser for Bartholin gland cysts.
METHODS
Thirty-one women with Bartholin gland cysts were treated with CO2laser at an outpatient´s setting. Skin incision was performed with focused laser beam, the capsule was opened to drain mucoid content, followed by internal vaporization of impaired capsule.
RESULTS
There were no complications. Five patients had recurrence of the cyst and were submitted to a second and successful session.
CONCLUSION
CO2 laser surgery was effective to treat Bartholin gland cysts with minimal or no complications, and can be performed at an outpatient´s setting.
Topics: Adult; Ambulatory Surgical Procedures; Bartholin's Glands; Cysts; Drainage; Female; Humans; Lasers, Gas; Male; Middle Aged; Postoperative Care; Recurrence; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 27074230
DOI: 10.1590/S1679-45082016AO3568 -
Taiwanese Journal of Obstetrics &... Sep 2021To present a case of vulvar myoma and the factors differentiating this tumor from Bartholin's cyst. (Review)
Review
OBJECTIVE
To present a case of vulvar myoma and the factors differentiating this tumor from Bartholin's cyst.
CASE REPORT
A 50-year-old woman presented with a nodule over the left labia majora. Pelvic examination showed swelling and redness of the left labia majora. A 2-cm nodule with firm consistency was found near the vaginal opening. There was no inguinal lymphadenopathy. Bartholin's cyst was suggested, and oral cephalexin was prescribed for 1 week, but no improvement was seen. Therefore, she underwent excision of the nodule. Pathology revealed it to be a benign vulvar myoma. The patient recovered well, and no recurrence was noted after 2 months of follow-up.
CONCLUSION
Vulvar myoma is rare. Sexual history, nodule consistency, and imaging are helpful, but the final diagnosis of vulvar myoma is usually made following surgical excision and histopathological analysis.
Topics: Bartholin's Glands; Biopsy; Cysts; Female; Humans; Leiomyoma; Middle Aged; Myoma; Treatment Outcome; Vulvar Neoplasms
PubMed: 34507676
DOI: 10.1016/j.tjog.2021.07.026 -
The American Journal of Pathology Mar 1993In this study, we examine 10 primary carcinomas of Bartholin's gland, including seven squamous carcinomas, two adenoid cystic carcinomas, and one adenocarcinoma, as well...
In this study, we examine 10 primary carcinomas of Bartholin's gland, including seven squamous carcinomas, two adenoid cystic carcinomas, and one adenocarcinoma, as well as four non-neoplastic Bartholin's gland. Six of seven squamous cell carcinomas contained human papillomavirus (HPV) type 16 DNA detectable by the polymerase chain reaction; one of these demonstrated HPV type 16 by in situ hybridization. The two adenoid cystic carcinomas, the adenocarcinoma, and the non-neoplastic Bartholin's gland epithelium showed no evidence of HPV DNA by polymerase chain reaction or in situ hybridization. A panel of eight antibodies (Cam 5.2, B72.3, CEA, EMA, MCA, Lewis X, ER, and PR) demonstrate that the squamous, transition zone, duct, acinar, and myoepithelial cells or Bartholin's gland are antigenically distinct, and are similar to those reported in analogous areas of the uterine cervix. Squamous carcinoma and adenocarcinomas of Bartholin's gland are antigenically similar, and seem to arise from the transition zone of the Bartholin's gland duct. The origin of adenoid cystic carcinomas is more difficult to determine; it is distinct from squamous and adenocarcinomas and seems more likely to arise from myoepithelial cells. We conclude that adenocarcinoma and squamous cell carcinoma of Bartholin's gland arise in the transition zone of Bartholin's gland, which is similar to the transition zone of the uterine cervix. We also show that HPV is associated with Bartholin's gland carcinoma and may play a role in the genesis of malignancy.
Topics: Adult; Aged; Bartholin's Glands; Carcinoma; DNA, Viral; Female; Genital Neoplasms, Female; Humans; Immunohistochemistry; In Situ Hybridization; Middle Aged; Papillomaviridae; Polymerase Chain Reaction; Tumor Virus Infections
PubMed: 8384409
DOI: No ID Found -
International Journal of Surgery Case... Apr 2022Leiomyoma, known as a disease of the uterus, composed of spindle-shaped smooth muscle fibers and collagenous stroma, is rarely encountered in other sites especially in...
INTRODUCTION AND IMPORTANCE
Leiomyoma, known as a disease of the uterus, composed of spindle-shaped smooth muscle fibers and collagenous stroma, is rarely encountered in other sites especially in the vagina.
CASE PRESENTATION
We report, here, an exceptional case of a vaginal leiomyoma situated in the anterior vaginal wall suggesting in the first place a cystocele. The MRI objectified a rounded formation of the anterior wall of the vagina with regular contours highly suggestive of a vaginal leimyoma. The tumor was surgically removed by the vaginal route. The histopathologic examination confirmed the diagnosis of vaginal leiomyoma.
CLINICAL DISCUSSION
Vaginal leiomyomas are commonly seen in women between the ages of 35 and 50 and are believed to be more common in Caucasian women. Although a rare tumor, vaginal leiomyomas may present with a variety of clinical features and may be mistaken preoperatively for a cystocele, urethrocele, Skene's duct abscess, Gartner's duct cysts, urethral diverticulum, vaginal cysts, cysts Bartholin's gland or a malignant vaginal tumor. The diagnosis is based on careful examination and preoperative imaging (ultrasonography and MRI). Removal of the tumor by vaginal route, wherever possible, with subsequent histopathological examination appears to be the optimum management plan. Although the lesion is benign, local recurrences following incomplete resection and sarcomatous changes have been reported.
CONCLUSION
Vaginal leiomyoma is a rare benign tumor. The diagnosis is often made only postoperatively after resection of the mass. The tumors may be found in any location within the vagina but are most commonly located on an anterior wall. Imaging can confirm the vaginal origin of the lesion. Surgical excision is the treatment of choice. The diagnosis is based on the histological study of the tumor.
PubMed: 35364392
DOI: 10.1016/j.ijscr.2022.106955 -
Oncology Letters Aug 2014Bartholin gland carcinomas (BGCs) are extremely rare tumors accounting for <1% of all female genital malignancies. The current study presents a 49-year-old female with...
Bartholin gland carcinomas (BGCs) are extremely rare tumors accounting for <1% of all female genital malignancies. The current study presents a 49-year-old female with an eight-year history of BGC. A mass was identified in the vulva and the patient underwent an excisional biopsy, which revealed a left Bartholin adenoid cystic carcinoma. The patient subsequently received surgery, chemotherapy and biological therapy, and has survived. Therefore, the present case indicates that surgery is important for the treatment of BGC, however; multimodal therapy may be a more effective treatment strategy.
PubMed: 25013508
DOI: 10.3892/ol.2014.2200