A Very Rare Case of Adenocarcinoma of Bartholin's Gland

Abstract

Abstract

Background: Among vulvar neoplasms, 0.1%–5% originate from a Bartholin's gland. Primary adenocarcinoma of a Bartholin's gland is very rare. To date, only ∼65 cases have been reported in the world literature. This article describes a rare case of a Bartholin's gland adenocarcinoma and its management. Case: A 45-year-old female, para 7, 7 living, who was tubectomized 10 years prior to presentation complained of having a mass in her vagina for 1 year. On examination, a 5×5–cms hard but tender swelling, in the region of the left Bartholin's gland, free from the pubic ramus, was felt. No obvious ulceration was seen. Her vaginal mucosa was intact. On rectal examination, the mucosa and parametria were noted to be free. Based on these findings, a clinical diagnosis of Bartholin's duct or gland malignancy was made. A transperineal ultrasound-guided scan showed a 4.4×5.3×4 cm well-defined hypoechoic focal lesion in the entire vagina extending up to the external surface of the vulva. A computed tomography scan showed an enhanced, well-defined exophytic mass of 5.2×4.6×4.5 cm along the left lateral wall of her vagina. A biopsy of the mass showed an adenocarcinoma of the Bartholin's gland with perineural invasion. This patient underwent a left Bartholin's adenectomy with reconstruction. Results: The patient's postoperative course uneventful. She was healthy and was discharged to go home. A follow-up is planned for radiotherapy, as of this writing. Conclusions: Surgery is the mainstay treatment of Bartholin's gland adenocarcinoma with or without radiotherapy. (J GYNECOL SURG 30:155)