Failure of sentinel node identification following neo-adjuvant chemo-radiotherapy for locally advanced squamous cell carcinoma of the vulva.
A case of a 70-year-old patient with advanced local vulvar cancer is presented. Treatment with neo-adjuvant chemo-radiotherapy for two courses was administered and two weeks after completion of treatment the patient underwent wide local excision with bilateral inguino-femoral lymph node dissection through three separate incisions. Two methods for the evaluation of sentinel nodes--lymphoscintigraphy and intraoperative gamma hand-held probe and blue dye injection, did not detect any sentinel node on either side. Groin-node dissection revealed 23 negative nodes. It is our hypothesis that the non-visualization of sentinel nodes in this patient was due to post-irradiation damage to the lymph channels.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Rabin Medical Center, Petah Tiqva, Israel.
H
H
Levavi
G
G
Sabah
R
R
Hardoff
C
C
Koren
H
H
Gutman
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000528:radiation effects; D020360:Neoadjuvant Therapy; D021701:Sentinel Lymph Node Biopsy; D014846:Vulvar Neoplasms / Q000473:pathology / Q000628:therapy*