Adenoid cystic carcinoma of Bartholin's gland: what is the optimal approach?

Aims and methods: We report the case of a locally advanced adenoid cystic c arcinoma of Bartholin's gland which required posterior pelvic exenteration, radical vulvectomy and ablation of the ischiorectal fossa in order to obta in tumour clearance with negative margins. Including This Case, only three pelvectomies have been performed for this disease. This is the first report ed case in which a controlateral unsuspected intravulvar metastasis was fou nd on histology. Results and conclusions: No consensus exists on the adequate surgical manag ement of this particular disease. Nevertheless, a review of the literature and this reported case suggest that radical vulvectomy with negative margin s should be preferred to wide local excision as the primary surgical proced ure. It also suggests that inguinofemoral lymph-node dissection should only be performed when suspect lymph nodes are found at clinical examination.