Mistake in diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Adverse events of drug therapy , Educational Purpose (only if useful for a systematic review or synthesis), Rare co-existance of disease or pathology
Wei Zhang, Yongyi Wang, Wei Chen, Jingyun Du, Libing Xiang, Shuang Ye, Huijuan Yang
(Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China (mainland))
Am J Case Rep 2019; 20:551-556
Verrucous carcinoma (VC) of the vulva is a variation of squamous carcinoma (SCC). Etiology and treatment of VC are still unclear.
CASE REPORT: A 50-year-old female visited our clinic with a giant vulvar tumor (8 cm of diameter maximum). Biopsy revealed a suspicious well differentiation squamous cancer. PET/CT (positron emission tomography/computed tomography) scan found suspicious lymph node in bilateral iliac vessel region and bilateral inguinal region. She underwent radical vulvectomy and bilateral inguinal lymph node dissection, and bilateral pelvic lymph node dissection. Pathology turns out to be VC and no lymph nodes involvement. Due to the large defection, vulvar reconstruction was performed 5 weeks later using skin grafts and pudendal thigh flap. This patient was disease free after 12 months follow-up.
CONCLUSIONS: In patients with VC, a satisfactory biopsy is important and systemic inguinal lymphadenectomy might be omitted. For patients with large defection, flap-based reconstruction is recommended.
Keywords: Carcinoma, Squamous Cell, Carcinoma, Verrucous, Lymph Node Excision, Vulvar Neoplasms