Oxford Gynaecological Cancer Centre, Churchill Hospital, Oxford University Hospitals Foundation Trust, Oxford, UK.
ElShatby Maternity University Hospital, Gynecology Oncology Center, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Int J Gynaecol Obstet. 2023 Dec;163(3):744-746. doi: 10.1002/ijgo.14880. Epub 2023 May 23.
To our knowledge, this is the first reported case of synchronous ovarian and vulva (Bartholin gland) cancer. A postmenopausal woman presented with a complex multiloculated left adnexal mass and 2-cm right Bartholin gland mass. CA 125 was 59 IU/mL. Computed tomography of chest, abdomen, and pelvis showed a very large (32 × 13.5 × 22.5 cm) complex mass arising from the pelvis and extending to the level of the T12/L1 disk space. A right Bartholin mass with suspicious right inguinal nodes was seen. Midline laparotomy, total abdominal hysterectomy, bilateral salpingo-oophrectomy, infracolic omentectomy, pelvic peritoneal biopsies, and peritoneal washings were carried out. Wide local excision of the right Bartholin gland mass was carried out in the same setting. Histopathology came back as Stage 2B left ovarian clear-cell carcinoma and synchronous right Bartholin gland adenoid cystic carcinoma with lymphovascular invasion, incompletely excised, staged at least FIGO Stage 1B. Following local multidisciplinary team discussion and positron emission tomography scan review, the local committee agreed to start three cycles of adjuvant chemotherapy then proceed with Bartholin gland scar re-excision and bilateral groin lymph node dissection. After the three cycles, the groin lymph nodes came back as metastatic adenocarcinoma with overall morphologic and immunohistochemical features consistent with metastatic ovarian clear-cell carcinoma. Postoperative adjuvant chemotherapy was given. Initial follow-up period over 9 months was uneventful.
据我们所知，这是首例同时发生卵巢和外阴（巴氏腺）癌症的报告病例。一名绝经后妇女出现复杂的多房性左侧附件肿块和 2 厘米右侧巴氏腺肿块。CA 125 为 59IU/mL。胸部、腹部和骨盆的计算机断层扫描显示一个非常大的（32×13.5×22.5 厘米）复杂肿块起源于骨盆并延伸至 T12/L1 椎间盘水平。右侧巴氏腺肿块伴有可疑右侧腹股沟淋巴结。进行了中线剖腹术、全子宫切除术、双侧输卵管卵巢切除术、结肠下网膜切除术、盆腔腹膜活检和腹膜冲洗。在同一部位进行了右侧巴氏腺肿块的广泛局部切除术。组织病理学结果为左侧卵巢透明细胞癌 2B 期，同时发生右侧巴氏腺腺样囊性癌伴血管淋巴管浸润，未完全切除，分期至少为 FIGO 1B 期。在进行局部多学科团队讨论和正电子发射断层扫描回顾后，当地委员会同意开始进行三周期辅助化疗，然后进行巴氏腺疤痕再次切除术和双侧腹股沟淋巴结清扫术。三个周期后，腹股沟淋巴结呈转移性腺癌，整体形态学和免疫组织化学特征与转移性卵巢透明细胞癌一致。给予术后辅助化疗。最初的 9 个月随访期无异常。
