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宫颈癌治疗后外阴淋巴管扩张症:一例报告及文献综述

Vulvar Lymphangiectasia After Therapy for Cervical Cancer: A Case Report and Literature Review.

作者信息

Pinto Vincenzo, Clark Christopher, Di Nanni Doriana, Vitagliano Amerigo, Pinto Grazia, Cazzato Gerardo

机构信息

Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy.

Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", 70124 Bari, Italy.

出版信息

J Clin Med. 2025 Mar 1;14(5):1675. doi: 10.3390/jcm14051675.

Abstract

: Vulvar lymphangiectasia (VLA) is a rare condition characterized by the abnormal dilation of lymphatic vessels in the vulvar region, often secondary to surgery or radiation therapy for malignancies. Its clinical presentation closely resembles other dermatological conditions, posing challenges for accurate diagnosis and appropriate management. This study aims to present a rare case of VLA occurring decades after cervical carcinoma surgery, contributing to the limited literature on this condition and offering insights into its differential diagnosis and management. A 70-year-old female patient presented with multiple fluid-filled vesicles in the vulvar region appearing 36 years after undergoing radical hysterectomy with pelvic lymphadenectomy for cervical carcinoma. The lesions were biopsied, and histopathological and immunohistochemical analyses were performed to confirm the diagnosis. A review of the existing literature on VLA was conducted to contextualize this case. A histopathological examination revealed papillomatous lesions with hyper-keratosis, dilated lymphatic vessels, and no signs of atypia, consistent with VLA. An immunohistochemical analysis confirmed the lymphatic nature of the lesions. Due to the patient's comorbidities, asymptomatic presentation, and lesion stability, conservative management with regular follow-up was chosen. No progression or complications were observed during the 12-month follow-up period. : This case highlights the importance of considering VLA in patients presenting with vulvar vesicles, especially those with a history of lymphatic disruption. An accurate diagnosis through histopathological and immunohistochemical techniques is essential to distinguish VLA from other conditions. Conservative management may be appropriate for asymptomatic cases, but tailored therapeutic strategies are needed to address symptomatic or disfiguring lesions.

摘要

外阴淋巴管扩张症(VLA)是一种罕见病症,其特征为外阴区域淋巴管异常扩张,通常继发于恶性肿瘤的手术或放射治疗。其临床表现与其他皮肤病状况极为相似,给准确诊断和恰当管理带来挑战。本研究旨在呈现一例宫颈癌手术后数十年发生的罕见VLA病例,为关于该病症的有限文献增添内容,并提供其鉴别诊断和管理方面的见解。一名70岁女性患者在因宫颈癌接受根治性子宫切除术及盆腔淋巴结清扫术后36年,外阴区域出现多个充满液体的水疱。对病变进行了活检,并进行了组织病理学和免疫组织化学分析以确诊。对现有的关于VLA的文献进行了综述,以便将该病例置于背景中。组织病理学检查显示有乳头瘤样病变伴角化过度、淋巴管扩张,且无异型性迹象,符合VLA。免疫组织化学分析证实了病变的淋巴管性质。由于患者存在合并症、无症状表现以及病变稳定,选择了定期随访的保守管理方式。在12个月的随访期内未观察到进展或并发症。该病例凸显了在出现外阴水疱的患者中,尤其是有淋巴管破坏病史的患者中考虑VLA的重要性。通过组织病理学和免疫组织化学技术进行准确诊断对于将VLA与其他病症区分开来至关重要。保守管理可能适用于无症状病例,但对于有症状或毁容性病变需要制定针对性的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6eb/11900954/d10d113348a9/jcm-14-01675-g001.jpg

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