Management of Bartholin's Gland Carcinoma in a Perimenopausal Woman: A Case Report.
Przemysław Borawski, Robert Kulhawik, Dariusz Boroń, Tomasz Sirek, Kacper Boroń, Piotr Ossowski, Marcin Opławski, Beniamin Oskar Grabarek
Abstract
Open AccessBACKGROUND Bartholin's gland carcinoma represents less than 5% of all vulvar cancers and is typically identified in postmenopausal women. We present a case involving a 53-year-old woman with primary Bartholin's gland carcinoma. CASE REPORT Treatment included surgical removal of the tumor, followed by chemotherapy with paclitaxel and carboplatin and adjuvant radiotherapy. Imaging studies 6 months after treatment showed no evidence of recurrence. The patient died 5 years after cancer diagnosis due to coronavirus infection. Molecular and biochemical analyses included human papillomavirus (HPV) testing and evaluation of changes in carcinoembryonic antigen (CEA) and cancer antigen 19-9 (CA 19-9) levels before lesion excision (time 0), before curettage of the uterine cavity and cervical canal (time 1), before radical lesion excision (time 2), before chemotherapy (time 3) and radiotherapy (time 4), and at 6 months after treatment completion (time 5). Histological analysis confirmed the diagnosis of Bartholin's gland carcinoma. The implemented treatment produced expected results. No HPV genotypes were detected in the tumor sample, and the patient had no history of HPV infection. Significantly (P<0.05) higher CEA and CA 19-9 levels were observed in the preoperative period compared with remission. Tumor marker levels were significantly lower after chemotherapy and radiotherapy than at diagnosis. CONCLUSIONS Paclitaxel-carboplatin chemotherapy with radiotherapy produced expected outcomes. CEA and CA 19-9 may serve as useful markers of treatment response and cancer remission. Genomic or RNA sequencing and HPV genotyping of tumor samples are advisable, given the absence of a well-defined molecular profile for Bartholin's gland carcinoma.