Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, New York, USA.
Fertil Steril. 2010 Jan;93(1):267.e5-7. doi: 10.1016/j.fertnstert.2009.07.1007. Epub 2009 Dec 3.
Case report of a young woman with a rare vulvar malignancy who received treatment with a personalized multidisciplinary approach to balance management of her malignancy without compromising survival with her desire for future pregnancy.
Case report.
University hospital.
PATIENT(S): A 33-year-old woman, gravida 2, para 1-0-1-1, who had a diagnosis of synovial cell sarcoma of the vulva and who desired future fertility.
INTERVENTION(S): At multiple steps, treatment was planned to try to maximize fertility preservation without potentially affecting initial treatment, which included a radical hemivulvectomy with bilateral lymph node dissection, brachytherapy with interstitial needles (20 Gy), and external beam radiation therapy (50 Gy).
MAIN OUTCOME MEASURE(S): Treatment and eradication of the malignancy and achievement of a successful subsequent pregnancy and live birth.
RESULT(S): The patient had no evidence of disease for 2 years after treatment. During that time she received preconception counseling by both a perinatologist and a reproductive endocrinologist. She conceived with the use of ultrasound monitoring to time intercourse specifically with ovulation from the contralateral ovary and had an uncomplicated pregnancy with a term delivery.
CONCLUSION(S): By using several disciplines and subspecialists, this patient received personalized treatment for a rare cancer, focused at curing her cancer and optimizing her future fertility.
报告一例年轻女性罕见外阴恶性肿瘤病例，采用个体化多学科方法治疗，在不影响生存的情况下平衡管理恶性肿瘤，同时满足其未来妊娠的愿望。
病例报告。
大学医院。
一位 33 岁的女性，孕 2 产 1-0-1-1，诊断为外阴滑膜细胞肉瘤，希望保留生育能力。
在多个步骤中，计划进行治疗，试图最大限度地保留生育能力，而不影响初始治疗，初始治疗包括根治性外阴半切除术和双侧淋巴结清扫术、间质针近距离放疗（20Gy）和外照射放疗（50Gy）。
恶性肿瘤的治疗和消除，以及随后成功妊娠和活产。
治疗后 2 年内患者无疾病证据。在此期间，她接受了围产医生和生殖内分泌医生的孕前咨询。她通过超声监测排卵，从对侧卵巢安排特定时间进行性交，成功受孕，妊娠顺利，足月分娩。
通过使用多个学科和亚专科，该患者接受了针对罕见癌症的个体化治疗，重点是治愈癌症并优化未来的生育能力。
