title: Single large inguinal lymph node metastasis in human papillomavirus-induced early invasive vulvar cancer of the anterior fourchette in two young women.
abstract: The incidence of human papillomavirus (HPV)-induced vulvar cancer in young women is increasing and often presents as microinvasive or early invasive tumors in a grade 3 vulvar intraepithelial neoplasia. So far, the risk of lymph node metastases in early invasive vulvar carcinoma (depth of invasion 1.1-2.0 mm) is reported to be less than 8%. We present 2 cases of young women with early invasive vulvar cancers (depth of invasion 1.5 and 2.0 mm) induced by HPV 16 and 42. In both cases, the cancers are located between the clitoris and urethra and are each accompanied by one groin macro-metastatic lymph node. This case report highlights the necessity for complete inguinofemoral lymphadenectomy and/or adequate radiation therapy of the groin in early invasive tumors in young women to prevent cancer recurrence in the groin. Additionally, the indication for a sentinel node procedure in these specific cases requires particular caution.
authors.affiliation: Department of Obstetrics and Gynecology, Heinrich Heine University, Düsseldorf, Germany. hampl@med.uni-duesseldorf.de
authors.forename: Monika
authors.initials: M
authors.lastname: Hampl
authors.forename: Volkmar
authors.initials: V
authors.lastname: Kueppers
authors.forename: Hans Georg
authors.initials: HG
authors.lastname: Bender
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery / Q000821:virology*; D005260:Female; D052162:Human papillomavirus 16 / Q000254:growth & development*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D030361:Papillomavirus Infections / Q000473:pathology* / Q000821:virology; D014846:Vulvar Neoplasms / Q000473:pathology* / Q000601:surgery / Q000821:virology*