Amy Liebeskind, MD; Stephen Machnicki, MD; Dorothy Blackmun, MD

Disclosures

Appl Radiol. 2004;33(7) 

In This Article

Case Summary

A 53-year-old woman with no significant medical history presented to her gynecologist with vulvar pruritis. Physical examination revealed a firm mass in the region of the left Bartholin's gland, which was thought to be a Bartholin's gland cyst. The patient was taken to the operating room for a planned marsupialization procedure.

Upon incision of the left vaginal mucosa and exposure of the Bartholin's gland, the gland was found to be solid and enlarged. A tissue specimen was obtained and was sent for pathologic evaluation. Microscopic examination revealed near complete replacement of the Bartholin's gland by invasive poorly differentiated keratinizing squamous cell carcinoma that appeared to arise from the duct of the Bartholin's gland, given the presence of scattered benign-appearing residual vestibular glands (Figure 1A). Extensive necrosis was present, as well as diffuse involvement of soft tissue and skeletal muscle. Vascular (Figure 1B) and perineural invasion were also identified. The margins of the specimen were positive for tumor involvement.

(A) Squamous carcinoma encroaches on the few residual benign tubuloalveolar glands of Bartholin's gland origin. (B) Extensive perineural and vascular invasion were present. A vessel partially occluded by tumor thrombus is pictured above.

(A) Squamous carcinoma encroaches on the few residual benign tubuloalveolar glands of Bartholin's gland origin. (B) Extensive perineural and vascular invasion were present. A vessel partially occluded by tumor thrombus is pictured above.

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