Hampl Monika, Kueppers Volkmar, Bender Hans Georg
Department of Obstetrics and Gynecology, Heinrich Heine University, Düsseldorf, Germany.
Gynecol Obstet Invest. 2009;67(1):42-5. doi: 10.1159/000159178. Epub 2008 Oct 2.
The incidence of human papillomavirus (HPV)-induced vulvar cancer in young women is increasing and often presents as microinvasive or early invasive tumors in a grade 3 vulvar intraepithelial neoplasia. So far, the risk of lymph node metastases in early invasive vulvar carcinoma (depth of invasion 1.1-2.0 mm) is reported to be less than 8%. We present 2 cases of young women with early invasive vulvar cancers (depth of invasion 1.5 and 2.0 mm) induced by HPV 16 and 42. In both cases, the cancers are located between the clitoris and urethra and are each accompanied by one groin macro-metastatic lymph node. This case report highlights the necessity for complete inguinofemoral lymphadenectomy and/or adequate radiation therapy of the groin in early invasive tumors in young women to prevent cancer recurrence in the groin. Additionally, the indication for a sentinel node procedure in these specific cases requires particular caution.
年轻女性中由人乳头瘤病毒（HPV）诱发的外阴癌发病率正在上升，且常在3级外阴上皮内瘤变中表现为微浸润性或早期浸润性肿瘤。到目前为止，据报道早期浸润性外阴癌（浸润深度1.1 - 2.0毫米）发生淋巴结转移的风险低于8%。我们报告了2例由HPV 16和42诱发的年轻女性早期浸润性外阴癌病例（浸润深度分别为1.5毫米和2.0毫米）。在这两个病例中，癌症均位于阴蒂和尿道之间，且每个病例均伴有一个腹股沟区的宏观转移性淋巴结。本病例报告强调了对于年轻女性早期浸润性肿瘤进行完整的腹股沟股淋巴结清扫术和/或腹股沟区充分放疗以预防腹股沟区癌症复发的必要性。此外，在这些特定病例中，前哨淋巴结手术的指征需要格外谨慎。
