title: Salvage hemipelvis radiotherapy with fertility preservation in an adolescent with recurrent vulvar carcinoma.
abstract: BACKGROUND
  To preserve fertility, hemi-pelvis irradiation was chosen for locoregional groin recurrence of vulvar cancer in an adolescent.
  
  
  METHODS
  A case of squamous cell vulvar carcinoma in uncommonly young patient is presented. First surgical management (local excision of T1N0M0 tumor of the right labia minora) was performed at the age of 16.5 years. Further therapy included wide local resection of recurrent local lesion, two subsequent ipsilateral groin dissections of nodal metastases (with extranodal spread at the first instance), and ipsilateral pelvic lymphadenectomy. The patient was administered external beam irradiation of 45 Gy to the hemi-pelvis followed by 10.8 Gy boost to the right inguinal region. After 6.5 years from the completion of radiotherapy the patient is free of disease. She managed to conceive but the labor was premature and the infant died in its 7th week of life.
  
  
  CONCLUSIONS
  In this case salvage hemi-pelvic irradiation for groin metastases of vulvar cancer has proved to be an effective treatment, allowing preservation of hormonal and obstetric functions. Partial post-irradiation damage of the uterus might have caused premature labor. Thus, special obstetric care is advisable in such situations.
authors.affiliation: Department of Oncology and Radiotherapy, Medical University of Gdańsk, 7 Debinki Street, 80-211 Gdańsk, Poland. oncol@amg.gda.pl
authors.forename: Krystyna
authors.initials: K
authors.lastname: Serkies
authors.forename: Barbara
authors.initials: B
authors.lastname: Wysocka
authors.forename: Janusz
authors.initials: J
authors.lastname: Emerich
authors.forename: Maria
authors.initials: M
authors.lastname: Hrabowska
authors.forename: Jacek
authors.initials: J
authors.lastname: Jassem
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D005260:Female; D005298:Fertility; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D016879:Salvage Therapy; D014846:Vulvar Neoplasms / Q000532:radiotherapy*