Valenzano Menada M, Papadia A, Lorenzi P, Fulcheri E, Ragni N
Department of Obstetrics and Gynecology, University of Genoa, San Martino Hospital, Genoa, Italy.
Eur J Gynaecol Oncol. 2003;24(6):577-9.
Vulvar metastases are the third largest group of malignant tumors of the vulva. We report the tenth case of breast cancer vulvar metastases arising 11 years after the primary diagnosis of breast ductal carcinoma and the first occurring eight years after a local recurrence on a rectus abdominis myocutaneous flap.
A 49-year-old woman presented with a voluminous lump of the left labium majus and enlargement of the ipsilateral inguinal lymph nodes. The mass was removed together with the ipsilateral inguinal lymph nodes. Microscopic evaluation of the removed lump revealed massive carcinomatous infiltration. No in situ lesions nor normal breast tissue were identified.
Unusual breast cancer metastases sites should not be ruled out. Our case differs from the preceding cases because this patient underwent plastic surgery with reconstruction of the breast with a rectus abdominis myocutaneous flap one year after mastectomy and developed a local recurrence three years thereafter. It can be hypothesized that lymphatic spread through newly formed lymphatics occurred.
外阴转移瘤是外阴恶性肿瘤的第三大类型。我们报告了第十例乳腺癌外阴转移病例，该病例发生在乳腺导管癌初次诊断11年后，且是首例在腹直肌肌皮瓣局部复发八年后出现的乳腺癌外阴转移。
一名49岁女性，左侧大阴唇出现巨大肿块，同侧腹股沟淋巴结肿大。该肿块与同侧腹股沟淋巴结一并切除。对切除肿块的显微镜检查显示有大量癌浸润。未发现原位病变或正常乳腺组织。
不应排除乳腺癌转移到不常见部位的情况。我们的病例与之前的病例不同，因为该患者在乳房切除术后一年接受了腹直肌肌皮瓣乳房重建整形手术，三年后出现局部复发。可以推测，肿瘤是通过新形成的淋巴管发生淋巴转移的。
