Gynecology Oncology Department, Second Floor, Vali-e-Asr Hospital, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, 13185-1678, Keshavarz Blvd, 1219121 Tehran, Iran.
Int J Hematol. 2010 Apr;91(3):498-500. doi: 10.1007/s12185-010-0525-9. Epub 2010 Mar 10.
Fanconi's anemia is a rare autosomal recessive disorder which is rarely associated with squamous cell carcinoma (SCC) of the vulva. We report a 23-year-old virgin female with Fanconi's anemia and diabetes mellitus who presented with a history of 6-month ulcerative lesions of the vulva. Gynecologic examination disclosed a 1 x 2 cm ulcerated tumor lesion at the right labia minor near to the urethra. The biopsy showed a high-grade vulvar intraepithelial neoplasia (VIN III). She underwent wide local excision for this lesion. Pathologic examination of the surgically removed specimen revealed SCC of the vulva. Therefore, radical vulvectomy and bilateral inguino-femoral lymphadenectomy were performed. Due to the involvement of right inguinal lymph node, radiotherapy with a total dose of 45 Gy was delivered to mid-pelvis through antero-posterior/postero-anterior fields with 18 mV photon energies. Until her last follow-up about 1 year after the treatment, the patient was free of disease or any recurrence at the site of operation. Patients with Fanconi's anemia have the risk of developing SCC of the genital tract. Radical vulvectomy and lymphadenectomy along with radiotherapy were associated with a satisfactory outcome in 1-year follow-up period in the presented patient.
范可尼贫血是一种罕见的常染色体隐性遗传病,很少与外阴鳞状细胞癌(SCC)相关。我们报告了一例 23 岁的未婚女性,患有范可尼贫血和糖尿病,有 6 个月外阴溃疡性病变史。妇科检查显示右侧小阴唇靠近尿道处有 1 x 2 厘米溃疡肿瘤病变。活检显示高级别外阴上皮内瘤变(VIN III)。她因该病变接受了广泛局部切除术。手术切除标本的病理检查显示外阴 SCC。因此,进行了根治性外阴切除术和双侧腹股沟股淋巴结切除术。由于右侧腹股沟淋巴结受累,采用 18 mV 光子能量的前后/后前野,通过骨盆中部给予总剂量 45 Gy 的放疗。在治疗后大约 1 年的最后一次随访中,患者无疾病或手术部位复发。范可尼贫血患者有发生生殖道 SCC 的风险。根治性外阴切除术和淋巴结切除术加放疗在本患者的 1 年随访期间取得了满意的结果。