title: Synovial cell sarcoma of the vulva: multimodality treatment incorporating preoperative external-beam radiation, hemivulvectomy, flap reconstruction, interstitial brachytherapy, and chemotherapy.
abstract: BACKGROUND
  Vulvar synovial cell sarcomas are rare, with only four previously published cases in the literature. Traditionally, the primary management for these tumors has been surgery alone.
  
  
  METHODS
  We report a case of a large vulvar synovial cell sarcoma in a 50-year-old woman treated with comprehensive combined multimodality management, including preoperative intensity-modulated radiation therapy, radical hemivulvectomy, flap reconstruction, interstitial low-dose-rate brachytherapy boost, and adjuvant chemotherapy.
  
  
  CONCLUSIONS
  Based on this case and the limited data in the literature, multimodality treatment of advanced soft tissue sarcoma of the vulva may optimize local control and minimize toxicity while preserving sexual function.
authors.affiliation: Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, 75 Francis Street L2, Boston, Massachusetts, MA 02115, USA.
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Holloway
authors.forename: Anthony H
authors.initials: AH
authors.lastname: Russell
authors.forename: Michael
authors.initials: M
authors.lastname: Muto
authors.forename: Michele
authors.initials: M
authors.lastname: Albert
authors.forename: Akila N
authors.initials: AN
authors.lastname: Viswanathan
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001918:Brachytherapy / Q000379:methods*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D015080:Mesna / Q000008:administration & dosage; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D013584:Sarcoma, Synovial / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D013524:Surgical Flaps; D014846:Vulvar Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*
chemical_list: D004317:Doxorubicin; D015080:Mesna; D007069:Ifosfamide