Pregnancy Following Radical Vulvectomy for Carcinoma of the Vulva

How Can We Treat Vulvar Carcinoma in Pregnancy? A Systematic Review of the Literature

“…The patients' age range at presentation was 17-41 years (mean 30 years) (Table 1). The majority of cases was diagnosed in the United States (15 cases) [18,23,27,[29][30][31][35][36][37]40,41], 12 in Europe (5 United Kingdom, 3 France, 2 Germany, 1 Belgium, 1 Holland) [11][12][13]17,20,22,24,26,33,38,39], 6 in Asia (1 Iran, 1 Nepal, 1 Turkey, 1 Malaysia, 1 Saudi Arabia) [14,16,19,21,32,34], 2 in Australia [28] and 2 in Africa (1 Congo, 1 Nigeria) [15,25]. Eight patients were black [15,25,27,29,31,36,41], 6 were white/Caucasian [13,17,22,30,31,40], and 6 were of different Asian races [14,16,21,…”

“…Globally, the anterior/upper part of the vulva was involved in 22/37 (60%) cases [13,14,19,[21][22][23][24][25][26][27][28][29][30][31][32]34,36,38,39], and the posterior/lower portion in 10/37 (27%) cases [18,20,25,28,31,35,36,41] (Table 1, Table S1). Nine lesions were centered in the median anterior/upper (6 cases) [21,26,30,32,38] or median posterior/lower (3 cases) [18,35] part of the vulva, extending bilaterally. One case seemed confined to the mid vulvar part [36].…”

“…One case seemed confined to the mid vulvar part [36]. The clitoris/periclitoral area was infiltrated in 14/37 (38%) cases [13,19,21,23,24,26,28,[30][31][32]34,38,39], labium majus in 18/37 (49%) cases [13,15,[19][20][21][22][23]29,[31][32][33][34]36,37,40,41], labium minus in 11/37 (30%) cases [13,14,17,20,21,24,27,28,36], the posterior fourchette in 3 (8%) cases [18,20,28]. Unilateral [14,15,17,19,20,[22][23][24]…”

“…The size of vulvar lesions ranged from 0.3 to 15 cm (mean 3.6 cm) . VSCCs were described as raised (5 cases) [18,22,24,31,41], verrucous/exophytic/papillary/proliferative/fungating (11 cases) [17,20,21,25,28,32,[34][35][36]40], nodular (2 cases) [15,24], solid (1 case) [20], firm plaque/flat (2 case) [22,36], ulcerated (18 cases) [13,14,17,[20][21][22][26][27][28][29][30]33,35,36,[38][39][40], bleeding (1 case) [15], necrotic (3 cases) [20,21,26], painful (4 cases) [17,23,24,27], pigmented (1 case) [18], or abscess-like (1 case) [31].…”

“…No primary VSCCs invaded cervix or bladder at presentation, despite a patient developed acute urinary retention with disease progression [25] while another woman revealed a tumor extending within 1 mm of the urethra (1 case, 3%) [28]. Palpable inguinal lymph nodes (LNs) were found in 12/37 (33%) cases at presentation, either bilateral (6 cases) [13,20,21,27,32,35] or unilateral (5 cases: 3 left [31,38,39], 2 right [15,28]); in 1 case it was unclear if the palpable LNs were bilateral or unilateral [31].…”