Tamussino Karl F, Bader Arnim A, Lax Sigurd F, Aigner Reingard M, Winter Raimund
Department of Obstetrics and Gynecology, University of Graz, Austria.
Gynecol Oncol. 2002 Jul;86(1):99-101. doi: 10.1006/gyno.2002.6727.
The sentinel lymph node concept is attractive in vulvar cancer because of the potential to avoid the morbidity associated with formal groin dissection.
An 84-year-old patient with a T2 carcinoma of the anterior vulva underwent surgery including bilateral sentinel node excision after identification with technetium-labeled nanocolloid. Frozen section histology showed a tumor deposit <1 mm in diameter in a left groin node whereas four nodes in the right groin were apparently negative. Completion lymphadenectomy was performed only for the left groin. Final histology including serial sectioning showed a micrometastasis in one of seven nodes from the right groin; no further treatment was given. Sixteen months postoperatively the patient developed a recurrence in the right groin; the left groin was free of tumor.
This case indicates that groins with a micrometastasis detected by sentinel lymph node excision require further treatment.
前哨淋巴结概念对外阴癌具有吸引力，因为它有可能避免与腹股沟根治性清扫相关的发病率。
一名84岁的前外阴T2期癌患者接受了手术，包括在使用锝标记的纳米胶体识别后进行双侧前哨淋巴结切除。冰冻切片组织学显示左腹股沟淋巴结中有一个直径<1 mm的肿瘤沉积物，而右腹股沟的四个淋巴结明显为阴性。仅对左腹股沟进行了根治性淋巴结清扫。最终组织学检查包括连续切片显示右腹股沟七个淋巴结中有一个存在微转移；未给予进一步治疗。术后16个月，患者右腹股沟出现复发；左腹股沟无肿瘤。
该病例表明，通过前哨淋巴结切除检测到有微转移的腹股沟需要进一步治疗。
