Gao Yuewen, Li Hongqi, Li Changzhong
Department of Gynecology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Transl Cancer Res. 2022 Oct;11(10):3883-3889. doi: 10.21037/tcr-21-2634.
Adenoid cystic carcinoma (ACC) of the Bartholin's gland is a rare cancer of the female genital tract for which there is no consensus on treatment. As there are no current reports on neoadjuvant chemotherapy followed by surgery for this disease, our case explores the effectiveness of neoadjuvant chemotherapy.
We report a case of ACC of Bartholin's gland. The patient is a 69-year-old woman with a left vulvar mass. Pelvic magnetic resonance imaging (MRI) showed a left perineal occupying lesion with indistinct boundaries to the surrounding tissues. The patient received two cycles of neoadjuvant chemotherapy with a regimen of paclitaxel combined with cisplatin and the mass was significantly reduced. Subsequently, she received a radical vulvectomy and left inguinal lymph node dissection. The operation was successful, and the patient was treated with simultaneous radiotherapy and chemotherapy after the surgery. The patient is currently 14 months postoperative and reports no significant pain with normal urination and defecation. The pelvic MRI was reviewed regularly, and there was no sign of recurrence.
After neoadjuvant chemotherapy, the extent of the lesion was significantly reduced, which reduced the difficulty of surgery, thus reducing surgical complications and enabling complete resection of the tumor tissue. Based on the treatment of this patient, we speculate that preoperative neoadjuvant chemotherapy may be a better choice for patients with extensive and fixed lesions.
巴氏腺腺样囊性癌是一种罕见的女性生殖道癌症，目前对于其治疗尚无共识。由于目前尚无关于该疾病新辅助化疗后手术治疗的报道，我们的病例探讨了新辅助化疗的有效性。
我们报告一例巴氏腺腺样囊性癌病例。患者为一名69岁女性，左侧外阴有肿物。盆腔磁共振成像（MRI）显示左侧会阴占位性病变，与周围组织边界不清。患者接受了两周期以紫杉醇联合顺铂为方案的新辅助化疗，肿物明显缩小。随后，她接受了根治性外阴切除术及左侧腹股沟淋巴结清扫术。手术成功，术后患者接受同步放化疗。患者目前术后14个月，自述排尿和排便正常，无明显疼痛。定期复查盆腔MRI，未见复发迹象。
新辅助化疗后，病变范围明显缩小，降低了手术难度，从而减少了手术并发症，并能够完整切除肿瘤组织。基于该患者的治疗，我们推测术前新辅助化疗对于病变广泛且固定的患者可能是更好的选择。
