Basal cell carcinoma of the vulva with inguinal lymph node metastases

Hoffman, Mitchel S.; Roberts, William S.; Ruffolo, Eugene H.

doi:10.1016/0090-8258(88)90155-2

Cited by 31 publications

(22 citation statements)

References 15 publications

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“…This incidence is higher than the expected 2-3% reported in most previous studies [1,[3][4][5][6][8][9][10]12,13]. Nevertheless, some studies have shown that the relative frequency ranges from 0.8 to 14.7% [2,7,11].…”

Section: Discussioncontrasting

confidence: 71%

“…Although Jews of Asian-African origin (Sephardic) make up about 60% of the Jewish population in the south of Israel, we have noticed more Jewish women of European-American origin (Ashkenazi) (6/8) than those of Asian-African origin (Sephardic) (2/8) affected by vulvar BCC. Studies from the USA have shown that vulvar BCC is more prevalent in Caucasian women than in Black women [2,4,10,11].…”

Section: Discussionmentioning

confidence: 98%

“…Vulvar BCC shares many clinical features with vulvar squamous cell carcinoma [4,7,10]: (1) mean age at diagnosis is approximately 70 years; (2) there is a predilection for Caucasians; (3) prevailing presenting symptoms are lump, ulcer, itching, and bleeding; (4) very often, there is a delay in diagnosis; (5) most tumors are located on the labia majora.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Temesvary [14] was the first to report a case of vulvar BCC in 1926, and it has been estimated that since then 200-250 cases of vulvar BCC have been listed in the literature [6,10,12,13]. Clinically, vulvar BCC is an indolent, locally invasive lesion which hardly ever metastasizes [1,2,10,13]. As with cutaneous BCCs in general, the vast majority of patients with vulvar BCC are cured by wide local excision including a generous amount of underlying subcutaneous tissue, although the local recurrence rate is as high as 20% in some series [1,12].…”

Section: Introductionmentioning

confidence: 99%

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Basal cell carcinoma of the vulva

1999

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Section: Discussioncontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Basal cell carcinoma of the vulva

1999

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Radiation therapy in management of carcinoma of the vulva with emphasis on conservation therapy

Pérez

Grigsby

Galakatos

et al. 1993

Cancer

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Background. This report consists of a retrospective analysis of 50 patients with primary invasive and 17 with recurrent histologically confirmed vulvar carcinoma treated with radiation therapy for locoregional disease. Methods. Of the patients with primary tumors, 13 were treated with wide local excision plus radiation therapy; 13 had radical vulvectomy followed by irradiation to the operative fields and inguinal–femoral/pelvic lymph nodes; 8 received similar postoperative radiation therapy after partial or simple vulvectomy; 16 patients had radiation therapy alone after biopsy; and 17 had recurrent tumors treated with radiation therapy alone. Results. In patients treated with biopsy/local excision, local tumor control was 92–100% in T1–3N0 disease, 40% in similar stages with N1–3, and 27% in recurrent tumors. Among patients treated with partial/radical vulvectomy and radiation therapy, primary tumor control was 90% in those with T1–3 tumors and any nodal stage, 33% in those with any T stage and N3 lymph nodes, and 66% in patients with recurrent tumors. The actuarial 5‐year disease‐free survival rates were 87% for patients with T1N0 disease, 62% for those with T2–3N0 disease, 30% for those with T1–3N1 disease, and 11% for patients with recurrent tumors; there were no long‐term survivors with T4 or N2–3 disease. Four of 17 patients treated for postvulvectomy recurrent disease remain disease‐free after local tumor excision and radiation therapy. In patients with T1–2 tumors treated with biopsy/wide tumor excision and radiation therapy with doses less than 50 Gy, the local tumor control was 75% (three of four patients), in contrast to 100% (13 of 13 patients) with 50.01–65 Gy. With T3–4 tumors treated with local excision and radiation therapy, tumor control occurred in none of three patients with doses less than 50 Gy and 66% (six of nine) with 50.01–65 Gy. In patients with T1–2 tumors treated with partial/radical vulvectomy and radiation therapy, local tumor control was 75% (six of eight), regardless of dose level; in T3–4 tumors, it was 67% (four of six patients) with 50–60 Gy and 86% (six of seven) with 65–70 Gy. Differences were not statistically significant. There was no significant dose response for tumor control in the inguinal–femoral lymph nodes, with doses of 50 Gy being adequate for elective treatment of nonpalpable lymph nodes and 60–70 Gy controlling tumor growth in 75–80% of patients with N2–3 nodes when administered postoperatively, after partial or radical lymph node dissection. Significant treatment morbidity included one rectovaginal fistula, one case of proctitis, one rectal stricture, four bone/skin necroses, four vaginal necroses, and one groin abscess. Conclusions. Wide local tumor excision and radiation therapy or irradiation alone in T1–2 tumors is an alternative treatment to radical vulvectomy in controlling vulvar carcinoma, with significantly less morbidity. In comparison with reported rates for surgery alone, radiation therapy after radical vulvectomy for locally advanced tumors ...

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Metastatic basal cell carcinoma. Report of five cases

Snow

Sahl

et al. 1994

Cancer

206

234

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Background. Metastatic basal cell carcinoma (MBCC) is rare. Risk factors for the development of MBCC include a history of persistent basal cell carcinoma (BCC) for many years, refractory to conventional methods of treatment and previous radiation treatment either in early adulthood or for localized cancer. Most MBCC originate from large tumors. Methods. The authors report five patients with basal cell carcinomas (BCC) of the ear (two patients), scalp, inner canthus, and nasolabial fold that metastasized to the regional lymph nodes, skin, and submandibular gland. In addition, the authors reviewed more than 40 reports of MBCC (n = 65) from 1981 to 1991 and tabulated the primary tumors by size and depth of invasion according to TNM classification, a classification that previously has not been used for BCC. Results. The authors tabulated the size distribution of tumors of 45 patients with MBCC. The overall mean and median diameters of the primary BCC were 8.7 and 7.0 cm, respectively. The mean area of the primary MBCC lesion that originated on the face and trunk was 62 and 217 cm2, respectively. Using the TNM classification, approximately 9% of MBCC originate from tumors smaller than 10 cm2. In addition, the authors found that large (T2 and T3) and deep (T4) BCC account for approximately 75% of the metastatic tumors. Metastatic BCC from primary tumors smaller than 1 cm in diameter are exceptionally rare. Conclusions. Approximately 67% of MBCC (n = 238) originate from facial sites. Using the data base of the Mohs Surgery Clinic, the authors found that BCC greater than 3 cm in diameter have approximately a 1.9% incidence of metastasis, and the overall rate of metastases for morpheaform BCC is less than 1%. Patients with tumors classified as T3 and T4 lesions ideally should be followed up for 10 or more years for the remote possibility of the development of MBCC.

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Basal cell carcinoma of the vulva with inguinal lymph node metastases

Cited by 31 publications

References 15 publications

Basal cell carcinoma of the vulva

Basal cell carcinoma of the vulva

Radiation therapy in management of carcinoma of the vulva with emphasis on conservation therapy

Metastatic basal cell carcinoma. Report of five cases

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