Carcinoma of the Bartholin Gland: A Review of 33 Cases

Abstract

Objectives Primary carcinoma of the Bartholin's gland is a rare malignancy that accounts for approximately 5% of vulvar carcinomas. The objective of this study was to compare the outcomes of women with primary Bartholin's gland carcinoma to those with non-Bartholin's gland related vulvar carcinoma. Methods/Materials A retrospective chart review of 429 patients with invasive vulvar carcinoma evaluated at a single institution between 1993 and 2011 was performed. Medical records were reviewed for demographic data, pathologic information, treatment type, and recurrence/outcome information. These variables were compared between patients with primary Bartholin's gland carcinoma and patients with non-Bartholin's gland related vulvar carcinoma. Results Thirty-three (7.7%) of the 429 patients with invasive vulvar carcinoma had primary carcinoma of the Bartholin's gland. Twenty-nine patients (87.9%) had squamous cell histology and four (12.1%) had adenocarcinoma. When compared with non-Bartholin's gland related vulvar carcinoma, patients with primary Bartholin's gland carcinoma had a younger age at diagnosis (median 57 vs. 63 years, p=0.045), higher rate of stage III/IV disease (60.6% vs. 35.8%, p=0.008), and were more likely to receive radiation therapy (78.8% vs. 43.9%, p<0.001). However, there were no significant differences between the two groups with regards to histologic subtype, lymphovascular space involvement, perineural invasion, positive margins, recurrence-free survival, or overall survival. Conclusions Despite being diagnosed at a more advanced stage, patients with primary carcinoma of the Bartholin's gland appear to have similar oncologic outcomes and survival rates to patients with non-Bartholin's gland related vulvar carcinoma.

29-year-old with dyspareunia and vulvar mass: An unusual diagnosis of Bartholin's gland carcinoma

“…Most cases of adenoid cystic carcinoma of the Bartholin's gland present in seemingly benign ways. The most common complaints are burning pain, palpable mass, and swelling ( Akbarzadeh-Jahromi et al, 2014 ; Alsan et al, 2011 ; Bhalwal et al, 2016 ; Chamlian and Taylor, 1972 ; Hsu et al, 2013 ; Hwang et al, 2012 ; Nowak et al, 2014 ).The burning sensation is thought to be secondary to perineural involvement. Initial misdiagnosis or delayed diagnosis may occur in up to 50% of patients ( Chamlian and Taylor, 1972 ) due to the overlap of these complaints with benign conditions, such as cyst or abscess ( Chamlian and Taylor, 1972 ; Hsu et al, 2013 ) or endometriosis ( Akbarzadeh-Jahromi et al, 2014 ).…”

“…Vulvar cancer, including primary Bartholin's gland carcinoma, affects approximately 6190 women yearly with 1200 deaths in 2018 ( Siegel et al, 2018 ). Of these, 0.1% – 7% are Bartholin's gland in origin ( Bhalwal et al, 2016 ; Cardosi et al, 2001 ). Adenoid cystic carcinoma is an uncommon variant of Bartholin's gland carcinomas, accounting for 10–15% of Bartholin's gland malignancies, with fewer than 90 cases described ( Alsan et al, 2011 ; Bhalwal et al, 2016 ).…”

“…Of these, 0.1% – 7% are Bartholin's gland in origin ( Bhalwal et al, 2016 ; Cardosi et al, 2001 ). Adenoid cystic carcinoma is an uncommon variant of Bartholin's gland carcinomas, accounting for 10–15% of Bartholin's gland malignancies, with fewer than 90 cases described ( Alsan et al, 2011 ; Bhalwal et al, 2016 ). Adenoid cystic carcinoma is more commonly a salivary tumor.…”

Primary small cell neuroendocrine carcinoma of the Bartholin's gland: A case report

“…Due to the potentially aggressive behavior of SCNC, prompt diagnosis is required ( 8 ). However, SCNC of the BG is often diagnosed late since the lesions are deep within the vulva and present with similar symptoms to most vulvar diseases, including abscesses or cysts ( 9 ). Patients usually complain of pain, swelling on the vulva, dyspareunia and bleeding ( 10 , 11 ).…”

Adenoid Cystic Carcinoma of Bartholin’s Gland: What Is the Best Approach?

“…Clinically, an enlargement in the greater vestibular glands in postmenopausal women should raise suspicion of the presence of a tumor, and biopsy is recommended. ACC presents as a not friable mass on speculum examination, with a size ranging from 0.5 to 4 cm, and with a deeply infiltrative pattern of growth [7,[16][17][18][19][20][21][22][23][24][25][26][27][28][29].…”