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第56回・2018年・横浜
 

バルトリン腺原発の腺様嚢胞癌の一例

演題番号 : P30-4

[筆頭演者]
演者)岸田 薫:1 
[共同演者]
坂井 邦裕:1、田中 章子:1、米田 智子:1、西 大介:1、松浦 俊明:1、丸山 智義:1、加藤 誠也:2

1:済生会福岡総合病院・産婦人科、2:福岡総合病院・病理診断科

 

Primary Bartholin's gland cancer is rare, comprising 0.17% of all vulvar carcinoma. Adenoid cystic carcinoma (ACC) is a rare variant of Bartholin's gland carcinoma, accounting for 10-15% of all Bartholin's gland malignancies. We experienced a very rare case of Bartholin's gland ACC. A 50-year-old premenopausal woman with a left vulvar mass growing in size for the past 5 years was referred to our department since it started to cause pain. Based on vulvar examination, a solid nodular mass measuring approximately 3.0 cm x 3.0 cm, was palpated on the left side of the vagina. We performed the excisional biopsy for diagnosis. The resected tumor was a yellowish white nodular mass with no capsule. Histopathological examination showed a cribriform pattern of tubules and gland-like elements filled with basophilic mucin. Pathological diagnosis was ACC originating in the Bartholin's gland. Computed tomography showed no evidence of distant metastasis. The patient was diagnosed as stage IB vulvar cancer according to the International Federation of Gynecologists and Obstetricians classification (2008). The patient then underwent a left radical local excision. The firm ill-defined mass extended to the periosteum of the inferior pubic ramus. Due to the size of the perineal defect, V-Y advancement flap was created to fill the defect. Pathology confirmed ACC and perineural invasion was observed. The tumor margin was microscopically positive. She received postoperative adjuvant external beam radiation (a total of 60.4Gy). It has been 10 months since the surgery and she is currently free of recurrence. Bartholin's cysts and abscesses are relatively common cases of vulvar mass lesions, which includes a Bartholin's gland carcinoma in a few cases. The possibility of cancer should be considered in any women older than 40 years of age with a painful mass near the Bartholin's glands.

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臓器別:その他

手法別:集学的治療

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