Abstract

THERE ARE many articles on the treatment Of’ in SitU and invasive squamous-cell carcinoma of the vulva. Radical vulvectomy and bilateral inguinal lymphadenectomy with or without pelvic nodes dissection is generally accepted treatment for invasive carcinoma of the vulva. Many methods of treatment for in situ squamous-cell carcinoma of the vulva have been used. They range from topical application of 5-fluorouracil or local excision of the lesion to radical vulvectomy, but literature is lacking so far in reports on microinvasive carcinoma of the vulva. Whether this is due to the fact that microinvasive carcinoma of the vulva is a relatively rare finding or it is considered as a frank invasive carcinoma is not clear. Wharton and associates’ reported 25 cases of microinvasive squamous-cell carcinoma of the vulva (invasion of stroma to a depth of 5 mm. or less) treated at the University of Texas M. D. Anderson Hospital between 1944 and 1969. Ten patients in their series had lymphadenectomies. None of the nodes was positive. They believed that the result of their study justified further investigation regarding the treatment of the patients with microinvasive vulvar carcinoma by conservative surgery. We used to consider radical vulvectomy (without node dissection) as an adequate therapy for microinvasive squamous-cell carcinoma of the vulva until we found positive inguinal and pelvic nodes 19 months after vulvectomy in the following case.

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