title: Liposomal doxorubicin for treatment of metastatic chemorefractory vulvar adenocarcinoma.
abstract: BACKGROUND
  Primaryadenocarcinoma of the vulva is a rare entity, and for widely metastatic vulvar adenocarcinoma, no effective treatment has been established.
  
  
  METHODS
  A 65-year-old woman was diagnosed with regionally advanced vulvar adenocarcinoma, with bulky involvement of bilateral groin lymph nodes, and associated extramammary Paget's disease. Initial therapy consisted of multiagent chemotherapy and vulvar and groin irradiation, followed by radical vulvectomy with groin and pelvic lymph node dissection. She subsequently developed widely metastatic disease including brain, pulmonary, hepatic, osseus, and subcutaneous lesions. Treatment with liposomal doxorubicin (Doxil) resulted in dramatic regression of metastatic lesions and marked improvement in quality-of-life. She remains clinically well, greater than 1 year since initiating Doxil treatment for widely metastatic vulvar adenocarcinoma, and has surpassed 5 years of survival since her initial diagnosis.
  
  
  CONCLUSIONS
  We report the first case of Doxil used for the treatment of metastatic chemorefractory vulvar adenocarcinoma. We observed that Doxil was a well-tolerated and effective agent for this gynecologic malignancy, and warrants further investigation.
authors.affiliation: Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Stanford University School of Medicine, Stanford, CA 94303, USA.
authors.forename: Gloria S
authors.initials: GS
authors.lastname: Huang
authors.forename: Margrit
authors.initials: M
authors.lastname: Juretzka
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ciaravino
authors.forename: Sabine
authors.initials: S
authors.lastname: Kohler
authors.forename: Nelson N H
authors.initials: NN
authors.lastname: Teng
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D000368:Aged; D004317:Doxorubicin / Q000627:therapeutic use*; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis; D010145:Paget Disease, Extramammary / Q000150:complications; D014846:Vulvar Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology
chemical_list: D004317:Doxorubicin