Radical vulvectomy for squamous cell carcinoma of the vulva

Twenty-one patients with squamous cell carcinoma of the vulva who were subjected to radical vulvectomy and inguinal-pelvic lymphadenectomy were studied. The overall mortality rate was 24%. Operative- and tumor-related mortalities were 9.5% and 14.2%, respectively. Recurrence was seen in 5 patients. The most common complication was wound infection and breakdown.     

Proctectomy combined with vulvectomy for carcinoma of the vulva

Carcinoma of the vulva occasionally involves the anal canal and the lower rectum. A method is presented for removal of the vulva, anus, and distal rectum by the perineal approach.     

A comparative study of radical vulvectomy and modified radical vulvectomy for the treatment of invasive squamous cell carcinoma of the vulva.

Forty-five patients who underwent a modified radical vulvectomy for invasive squamous cell carcinoma of the vulva were compared with forty-five patients who underwent radical vulvectomy for similar lesions. Vulvar wound infection and breakdown were infrequent in both groups. Anal incontinence developed postoperatively in five of the modified radical vulvectomy patients and in none of the radical vulvectomy patients. Urinary incontinence developed postoperatively in two of the modified radical vulvectomy patients and in seven of the radical vulvectomy patients. Possible reasons for these differences are discussed. One invasive local recurrence (2.2%) developed in the modified radical vulvectomy group and two (4.4%) local recurrences developed in the radical vulvectomy group. A modified radical vulvectomy appears to be efficacious for the vulvar phase of treatment of localized invasive squamous cell carcinoma of the vulva.     

Skinning vulvectomy in the treatment of carcinoma in situ of the vulva--case report

There has been a case presented of multifoci preinvasive cancer in a twenty three years old female. In the case an operation has been performed involving a superficial excision of the changing vulvar skin. On the basis of meta-analysis we compared the efficiency of the performed surgical method and other destructive techniques used in the intraepithelial vulvar neoplasm treatment.     

Treatment of cutaneous vulvar lesions with skinning vulvectomy

A skinning vulvectomy and split-thickness skin graft were used in the management of four women with benign vulvar disease after the failure of standard medical and surgical therapy. Three women remain free of the primary disease process, with a follow-up of 12-36 months. One woman with lichen sclerosus and another with "diffuse atrophy" developed recurrent disease in their skin grafts 45 and 96 months, respectively, after skinning vulvectomy. Symptomatic improvement was achieved subsequently in both women with the topical application of testosterone.     

Management of carcinoma in situ of the vulva

Concern about multicentricity and occult invasion has led authorities to recommend total vulvectomy in the management of carcinoma in situ of the vulva (VCIS). Of these considerations, only occult invasion has sufficient import to contraindicate a more conservative therapeutic approach. VCIS is being diagnosed with increasing frequency in young women for whom the deforming and sexually crippling effects of vulvectomy are especially repugnant. Because of its distinctive success in localizing preinvasive and early invasive squamous neoplasia of the cervix, colposcopy and directed biopsy were employed in evaluating all patients seen in our vulva clinic since 1971. Of 27 consecutive patients considered to have VCIS, 24 were treated either by local excision, skinning vulvectomy, topical 5-fluorouracil (5-FU), or cryosurgery. In no instance was occult invasion missed on pretreatment evaluation, and only one patient has developed a new in-situ lesion following conservative surgical therapy. Topical 5-FU therapy was unsuccessful in six of six cases. These results demonstrate that total vulvectomy for VCIS can be replaced successfully with more conservative operations.     

Topical 5-fluorouracil in the treatment of carcinoma in situ of the vulva.

The clinical and pathologic response of carcinoma in situ of the vulva in a 42-year-old woman treated with topical 5-fluorouracil is reported. Except for one persistent area of involvement in the anal region which required local excision, the result of treatment was excellent, with no evidence of recurrence after 2 years' followup. This important adjunct in the treatment of intra-epithelial carcinoma deserves long-range investigation.     

Recurrent carcinoma in situ of the vulva in a skin graft

Skinning vulvectomy has been a recommended treatment for carcinoma in situ of the vulva. We report a case of recurrent carcinoma in situ occurring in the skin graft of a patient with previous skinning vulvectomy.