Open Access Highly Accessed Case report

Challenging the concept of microinvasive carcinoma of the vulva: report of a case with regional lymph node recurrence and review of the literature

Jutta Sidor1*, Raihana Diallo-Danebrock2, Elke Eltze3 and Ralph J Lellé4

Author Affiliations

1 Department of Obstetrics and Gynecology, St. Joseph's Hospital, Berlin, Germany

2 Department of Pathology, Duesseldorf University, Germany

3 Department of Pathology, Muenster University, Muenster, Germany

4 Department of Obstetrics and Gynecology, Muenster University, Muenster, Germany

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BMC Cancer 2006, 6:157  doi:10.1186/1471-2407-6-157

Published: 14 June 2006

Abstract

Background

It is widely accepted that vulvar carcinoma with a depth of invasion of less than one millimeter is sufficiently treated by vulvectomy or wide local excision without inguinal lymphadenectomy.

Case presentation

However, a patient with inguinal lymph node recurrence 21 months after radical vulvectomy for stage IA squamous cell carcinoma was observed.

Conclusion

According to a review of the literature, there are five additional cases of metastasizing vulvar cancer with a depth of invasion of less than one millimeter. Therefore, the definition of microinvasive carcinoma of the vulva based on depth of invasion alone may not be as reliable as previously thought and does not rule out inguinal lymph node involvement or recurrence. Consequently, the necessity of inguinal node dissection for microinvasive carcinoma needs to be discussed on an individual basis taking into account the age of the patient as well as the potential morbidity of extended surgery.