PRETREATMENT SONOGRAPHIC EVALUATION OF INGUINAL LYMPH-NODES IN PATIENTS WITH VULVAR MALIGNANCY

The state of the inguinal nodes is a major prognostic factor in vulvar carcinoma. Because of new surgical trends with selective inguinal lym phadenectomy, the preoperative evaluation of inguinal lymph nodes is e ssential for adequate treatment of vulvar carcinoma. To evaluate the a dequacy of clinical examination and high-frequency transducer sonograp hy in detecting metastatic inguinal lymph nodes, we studied 25 patient s with vulvar malignancy who underwent operation. Histopathologically proved lymph node metastases were found in 11 (22%) of 50 inguinal are as studied. All of the suspected metastases were in patients with stag e III-IV disease. The inguinal lymph node metastases were found by son ography in nine (82%), by preoperative palpation in one (9%), and by o perative palpation in six (55%) of 11 areas. The difference between so nography and palpation was statistically significant (P < 0.01). The s ensitivity and specificity were 82% and 87% for sonography, 9% and 100 % for preoperative palpation, and 55% and 90% for operative palpation.