Rodríguez Verónica Garza, De la Fuente García Alberto, Torres Myrna Alejandra Cardoza, Flores Minerva Gómez, Moreno Gildardo Jaramillo, Candiani Jorge Ocampo
Department of Dermatology, University Hospital "Dr. José Eleuterio González", UANL, Monterrey, Nuevo León, México.
Indian Dermatol Online J. 2014 Apr;5(2):160-3. doi: 10.4103/2229-5178.131089.
Basal cell carcinomas (BCC) on the genital area account for less than 1% of all BCCs. Surgical management is indicated. Recurrence rate of vulvar BCC has been reported to be 10-20%. Mohs micrographic surgery (MMS) is a superior surgical option. Other treatments include radiation and topical immuntherapy. Cryosurgery for vulvar BCC has not been reported. We present the case of a 88-year-old Hispanic woman with a vulvar ulcer that was confirmed as BCC by histopathology and treated with liquid nitrogen cryosurgery. Control biopsy was performed on day 90 was negative for BCC. No clinical evidence of recurrence was detected after one year. Although, the vulva is considered to be a high-risk site with respect to BCC and MMS is the gold standard for treatment, the delicate nature of the area may preclude complete removal by a surgical technique without compromising vital anatomical function. Liquid nitrogen cryosurgery uses the effects of extreme cold to effect deep destruction of the tumor and surrounding tissues. This is the first report of a vulvar BCC successfully treated with liquid nitrogen cryosurgery. We suggest this technique could be of benefit as an alternative treatment in cases where excisional procedures cannot be performed.
生殖器部位的基底细胞癌（BCC）占所有基底细胞癌的比例不到1%。需进行手术治疗。据报道，外阴基底细胞癌的复发率为10%-20%。莫氏显微外科手术（MMS）是一种较好的手术选择。其他治疗方法包括放疗和局部免疫治疗。尚未见有关外阴基底细胞癌冷冻手术的报道。我们报告一例88岁西班牙裔女性患者，其外阴溃疡经组织病理学确诊为基底细胞癌，并接受了液氮冷冻手术治疗。术后90天进行的对照活检显示基底细胞癌阴性。一年后未发现复发的临床证据。尽管外阴被认为是基底细胞癌的高危部位，且莫氏显微外科手术是治疗的金标准，但该部位的特殊性质可能导致在不影响重要解剖功能的情况下无法通过手术技术完全切除肿瘤。液氮冷冻手术利用极寒效应深度破坏肿瘤及周围组织。这是首例成功采用液氮冷冻手术治疗外阴基底细胞癌的报道。我们认为，在无法进行切除手术的情况下，该技术可作为一种替代治疗方法发挥作用。
