Tartaglia E, Messalli E M, Di Serio M, Rotondi M, Mainini G, Di Serio C
Gynaecologic and Obstetric Department, "G. Moscati" Hospital of Aversa, Caserta, Italy.
Eur J Gynaecol Oncol. 2007;28(1):51-3.
Vulvar carcinoma is relatively rare gynaecologic malignancy. The most prevalent vulvar cancer is squamous cell carcinoma. It is not uncommon for patients to delay seeking medical attention or for physicians to delay diagnosing the condition. This delay results in many cases being diagnosed in advanced stage. The sentinel lymph node "concept" is attractive in vulvar cancer because it has the potential to avoid a radical vulvectomy associated with uni- or bilateral inguinofemoral lymphadenectomy and, thus, to avoid the morbidity associated with formal groin dissection.
A case of an 88-year-old woman with advanced local vulvar cancer is presented. A study of the inguinal-femoral lymph nodes was also conducted with intraoperative vital blue dye peritumoral injection and as the sentinel node was found to be negative for malignant metastasis, a radical vulvectomy without bilateral inguinofemoral lymphadenectomy and without additional treatment (chemotherapy and/or radiotherapy) was performed. Follow-up was performed at one, three, six, nine, 12, 18 and 24 months. No local recurrence or distant metastasis was found.
The sentinel lymph node procedure allows a less aggressive treatment to be carried out in patients with invasive vulvar cancer thus reducing the complications and morbidity of treatment. Moreover, reducing the operative stress can change the overall survival and reduce the mortality linked to complications and postoperative stress.
外阴癌是一种相对罕见的妇科恶性肿瘤。最常见的外阴癌是鳞状细胞癌。患者延迟就医或医生延迟诊断这种情况并不罕见。这种延迟导致许多病例在晚期才被诊断出来。前哨淋巴结“概念”在外阴癌中很有吸引力，因为它有可能避免与单侧或双侧腹股沟股淋巴结清扫术相关的根治性外阴切除术，从而避免与正规腹股沟清扫术相关的发病率。
介绍了一名88岁患有晚期局部外阴癌的女性病例。还通过术中在肿瘤周围注射活性蓝色染料对腹股沟股淋巴结进行了研究，由于发现前哨淋巴结无恶性转移，因此进行了无双侧腹股沟股淋巴结清扫术且无额外治疗（化疗和/或放疗）的根治性外阴切除术。在1、3、6、9、12、18和24个月进行了随访。未发现局部复发或远处转移。
前哨淋巴结手术可以对外阴浸润性癌患者进行侵袭性较小的治疗，从而减少治疗的并发症和发病率。此外，减轻手术应激可以改变总体生存率，并降低与并发症和术后应激相关的死亡率。
