title: Groin recurrence after micrometastasis in a sentinel lymph node in a patient with vulvar cancer.
abstract: BACKGROUND
  The sentinel lymph node concept is attractive in vulvar cancer because of the potential to avoid the morbidity associated with formal groin dissection.
  
  
  METHODS
  An 84-year-old patient with a T2 carcinoma of the anterior vulva underwent surgery including bilateral sentinel node excision after identification with technetium-labeled nanocolloid. Frozen section histology showed a tumor deposit <1 mm in diameter in a left groin node whereas four nodes in the right groin were apparently negative. Completion lymphadenectomy was performed only for the left groin. Final histology including serial sectioning showed a micrometastasis in one of seven nodes from the right groin; no further treatment was given. Sixteen months postoperatively the patient developed a recurrence in the right groin; the left groin was free of tumor.
  
  
  CONCLUSIONS
  This case indicates that groins with a micrometastasis detected by sentinel lymph node excision require further treatment.
authors.affiliation: Department of Obstetrics and Gynecology, University of Graz, Austria. karl.tamussino@kfunigraz.ac.at
authors.forename: Karl F
authors.initials: KF
authors.lastname: Tamussino
authors.forename: Arnim A
authors.initials: AA
authors.lastname: Bader
authors.forename: Sigurd F
authors.initials: SF
authors.lastname: Lax
authors.forename: Reingard M
authors.initials: RM
authors.lastname: Aigner
authors.forename: Raimund
authors.initials: R
authors.lastname: Winter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D021701:Sentinel Lymph Node Biopsy; D014846:Vulvar Neoplasms / Q000473:pathology* / Q000601:surgery