Journal article Open Access
Samara, Mariam; Somen, Ema; Mijatovic, Davor
Background: Vulvar carcinoma most often occurs on the outer surface area of the female genitalia. The vulva is the area of skin that surrounds the urethra and vagina, including the clitoris and labia. It is quite rare cancer of the female reproductive system and accounts for 3-4% of all genitourinary tract neoplasms. Though it can occur at any age, vulvar cancer is most common in older adults. When present in young women it is mostly associated with human papillomavirus (HPV)–related dysplasia. The most common histology is squamous cell carcinoma of the vulva.
Case study: This report presents a patient with verified planocellular vulvar carcinoma who underwent radical hysterectomy with adnexectomy and lymphadenectomy due to cervical neoplasm (squamous cell carcinoma). After chemo-radio therapy, the patient underwent radical vulvectomy and two months later, resection of the distal urethra and vulvar and vaginal reconstruction with gracilis muscle. Full-thickness skin graft was used to reconstruct the distal part of the urethra.
Conclusion: Combination of flaps and full-thickness skin graft can be used in reconstruction of vulva and urethra.
ACC2019No1 Patient with malignant vulvar neoplasm.pdf
Buchanan T, Mutch D. Squamous cell carcinoma of the vulva: a review of present management and future considerations. Expert Rev Anticancer Ther. 2019;19(1):43-5.
Del Pino M, Rodriguez-Carunchio L, Ordi J. Pathways of vulvar intraepithelial neoplasia and squamous cell carcinoma. Histopathology. 2013;62(1):161-75.
Dellinger TH, Hakim AA, Lee SJ, Wakabayashi MT, Morgan RJ, Han ES. Surgical Management of Vulvar Cancer. J Natl Compr Cancer Netw JNCCN. 2017;15(1):121–8.
Faber MT, Sand FL, Albieri V, Norrild B, Kjaer SK, Verdoodt F. Prevalence and type distribution of human papillomavirus in squamous cell carcinoma and intraepithelial neoplasia of the vulva. nt J Cancer. 2017;141(6):1161-1169.
Faiena I, Koprowski C, Tunuguntla H. Female Urethral Reconstruction. J Urol. 2016;195(3):557-67.
Hoag N, Chee J. Surgical management of female urethral strictures. Transl Androl Urol. 2017;6(Suppl 2):S76–80.
Mijatović D, Smud S, Dujmović A. Our experience in vulvar reconstruction after radical and hemivulvectomy. Lijec Vjesn. 2012;134(5–6):192–4.
Osman NI, Chapple CR. Contemporary surgical management of female urethral stricture disease. Curr Opin Urol. 2015;25(4):341–5
Te Grootenhuis NC, Pouwer AW, de Bock GH et al. Prognostic factors for local recurrence of squamous cell carcinoma of the vulva: A systematic review. Gynecol Oncol. 2018;148(3):622-631.