Objective： The aim of this study was to explore the new method of inguinal lymphadenectomy in order to reduce side effects of conventional method for patients with vulvar carcinoma. Methods： Lipolysis and liposuctio...Objective： The aim of this study was to explore the new method of inguinal lymphadenectomy in order to reduce side effects of conventional method for patients with vulvar carcinoma. Methods： Lipolysis and liposuction were performed to subcutaneous fat on inguinal region. We inserted endoscope and filled with C02 gases to this field and then resected inguinal lymph nodes with ultrasonic scalpel. The operative field was placed with the vacuum sealing drainage and pressured with soft saline bag after the operation. Results： Many lymphatic vessel, small blood vessels and hanging lymph nodes in the subcutaneous tissues of inguinal region were revealed after lipolysis and liposuction and lymph nodes can be easily removed. The follow-up so far showed that healing of the incision was good and there was no lymphedema of patient＇s lower limb and inguinal region. Conclusion： Endoscopic inguinal lymphadenectomy can resect the lymph nodes and keep most of the lym- phatic vessels. So this technique has less influence on the lymph backflow of lower limb and inguinal region and can avoid the huge incision of conventional method. This method is worthy of further study.展开更多
Granular cell tumors are rare,usually benign,soft tissue neoplasms of neural origin.They occur more often in females than males,the peak age incidence is in the fourth through fifth decades.They can occur anywhere in ...Granular cell tumors are rare,usually benign,soft tissue neoplasms of neural origin.They occur more often in females than males,the peak age incidence is in the fourth through fifth decades.They can occur anywhere in the body with up to 15% situated in the vulva.The commonest presentation is as an asymptomatic mass.Microscopic findings are usually sufficient,but immunohistochemistry can also be helpful in confirming the diagnosis.The vulvar tumors are benign in 98% of cases with 2% reported as malignant.In this case report we describe a woman with a granular cell tumor confirmed by biopsy who underwent excision of the mass but with focal extension to the resection margin on microscopy.Our recommendation of re-excision was declined.Since it is not uncommon with these tumors to find groups of tumor cells extending beyond the macroscopic limits of growth,we conclude that it is advisable to have margins assessed intraoperatively by frozen section such that further excision can be performed for positive margins.Our patient has been followed for 18 mo without recurrence,should the tumor recur,re-excision,with frozen section control,is indicated.Recurrence rates are reported as 2%-8% with clear margins and 20% with positive margins.展开更多
Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. Whe...Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. When present, these neoplasms often manifest with nonspecific signs and symptoms such as pain, itching, swelling, single-focus lesions, bleeding, and enlargement of inguinal lymph nodes, in addition to the presence of progressively enlarging vulvar nodules. Consequently, the diagnostic investigation involves histopathological examination and confirmation through immunohistochemistry. Objective: To present a comprehensive understanding of this rarely studied pathology. The primary objective is to provide valuable insights that could aid in the future development of universally applicable treatment guidelines. Case Presentation: A 57-year-old female, with no prior comorbidities, menopause at 36, who presented with a left vulvar nodule accompanied by intense pain and swelling, later diagnosed with small cell neuroendocrine carcinoma in the vulva. Conclusion: This case report highlights the importance of enhancing our knowledge regarding small cell neuroendocrine carcinoma in the vulva, given its scarcity in medical literature. The information presented here underscores the need for standardized diagnostic and treatment approaches, paving the way for future consensus on managing this uncommon but challenging neoplasm.展开更多
文摘Objective： The aim of this study was to explore the new method of inguinal lymphadenectomy in order to reduce side effects of conventional method for patients with vulvar carcinoma. Methods： Lipolysis and liposuction were performed to subcutaneous fat on inguinal region. We inserted endoscope and filled with C02 gases to this field and then resected inguinal lymph nodes with ultrasonic scalpel. The operative field was placed with the vacuum sealing drainage and pressured with soft saline bag after the operation. Results： Many lymphatic vessel, small blood vessels and hanging lymph nodes in the subcutaneous tissues of inguinal region were revealed after lipolysis and liposuction and lymph nodes can be easily removed. The follow-up so far showed that healing of the incision was good and there was no lymphedema of patient＇s lower limb and inguinal region. Conclusion： Endoscopic inguinal lymphadenectomy can resect the lymph nodes and keep most of the lym- phatic vessels. So this technique has less influence on the lymph backflow of lower limb and inguinal region and can avoid the huge incision of conventional method. This method is worthy of further study.
文摘Granular cell tumors are rare,usually benign,soft tissue neoplasms of neural origin.They occur more often in females than males,the peak age incidence is in the fourth through fifth decades.They can occur anywhere in the body with up to 15% situated in the vulva.The commonest presentation is as an asymptomatic mass.Microscopic findings are usually sufficient,but immunohistochemistry can also be helpful in confirming the diagnosis.The vulvar tumors are benign in 98% of cases with 2% reported as malignant.In this case report we describe a woman with a granular cell tumor confirmed by biopsy who underwent excision of the mass but with focal extension to the resection margin on microscopy.Our recommendation of re-excision was declined.Since it is not uncommon with these tumors to find groups of tumor cells extending beyond the macroscopic limits of growth,we conclude that it is advisable to have margins assessed intraoperatively by frozen section such that further excision can be performed for positive margins.Our patient has been followed for 18 mo without recurrence,should the tumor recur,re-excision,with frozen section control,is indicated.Recurrence rates are reported as 2%-8% with clear margins and 20% with positive margins.
文摘Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. When present, these neoplasms often manifest with nonspecific signs and symptoms such as pain, itching, swelling, single-focus lesions, bleeding, and enlargement of inguinal lymph nodes, in addition to the presence of progressively enlarging vulvar nodules. Consequently, the diagnostic investigation involves histopathological examination and confirmation through immunohistochemistry. Objective: To present a comprehensive understanding of this rarely studied pathology. The primary objective is to provide valuable insights that could aid in the future development of universally applicable treatment guidelines. Case Presentation: A 57-year-old female, with no prior comorbidities, menopause at 36, who presented with a left vulvar nodule accompanied by intense pain and swelling, later diagnosed with small cell neuroendocrine carcinoma in the vulva. Conclusion: This case report highlights the importance of enhancing our knowledge regarding small cell neuroendocrine carcinoma in the vulva, given its scarcity in medical literature. The information presented here underscores the need for standardized diagnostic and treatment approaches, paving the way for future consensus on managing this uncommon but challenging neoplasm.
