Bartholin gland carcinoma

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Bartholin gland carcinoma
Other namesBartholin's gland cancer, Bartholin's gland carcinoma (morphologic abnormality), carcinoma of Bartholin's gland (disorder) [1]
American journal of obstetrics and gynecology (1920) (14745090456).jpg
Barthlin carcinoma tissue cross section
Specialty Oncology, gynecology
Symptoms Painless soft swelling at one side of the vaginal opening [2]
Usual onsetTypically in the 50s [3]
CausesUnknown [2]
FrequencyRare, <1% of all female genital tract cancer, <5% of vulvar cancer [2]

Bartholin gland carcinoma is a type of cancer of the vulva arising in the Bartholin gland. [2] It typically presents with a painless mass at one side of the vaginal opening in a female of middle-age and older, and can appear similar to a Bartholin cyst. [2] The mass may be big or small, may be deep under skin or appear nearer the surface with overlying ulceration. [2] Average age at presentation is 53-years. [3]

Contents

The tumor can become large before a woman is aware of symptoms. One of the first symptoms can be painful sex. In other instances there may be a mass or ulcer in the vulva area. Many clinicians assume that an enlarged Bartholin gland is malignant in postmenopausal woman until proven otherwise. The growth of the tumor can spread to nearby areas such as the ischiorectal fossa and inguinal lymph nodes. Approximately 50% of bartholin gland carcinomas originate from squamous cell carcinomas. Another uncommon characteristic of Bartholin gland malignancies is that the growth of a lesion originates from the three types of epithelial tissue present in the gland: mucinous, transitional, and squamous. [4]

It is rare, accounts for less than 1% of all female genital tract cancer and less than 5% of all vulva cancer. [2]

Cause

The cause is unknown. [2]

Diagnosis

Bartholin gland can be differentiated by histology to determine whether the malignancy is due to squamous cell carcinoma, adenoid cystic carcinoma, or adenocarcinomas. [5]

Management

Though Bartholin gland carcinoma is rare, along with other unusual Bartholin gland growths, it many not be the typical practice for clinicians to consider lesions malignant. Early diagnosis can help to prevent the cancer from the glands to surrounding. Though malignancies of the Bartholin gland are rare clinicians biopsy Bartholin gland lesions in older women or when the growth reoccurs or does not respond to original treatment. [4]

Prognosis

The prognosis is optimistic as long as the growth has not metastasized to the lymph nodes. [4]

History

Bartholin glands were described in cattle by Casper Barthlin in 1677. Their existence in humans was postulated at that time. [4] Treatment can be a vulvectomy that results in the removal of the growth along with an extensive removal of adjacent tissue. An inguinal lymphadenectomy often accompanies the vulvectomy. The tissue that is removed sometimes includes sections of the vagina and rectum. [6]

Illustration of Bartholin glands vaginal abscesses. Diseases of women. A clinical guide to their diagnosis and treatment (1899) (14767986892).jpg
Illustration of Bartholin glands vaginal abscesses.

The adenoid cystic carcinoma of the Bartholin gland is another uncommon malignancy with symptoms that include local painful intermittent recurrences. The disease is slow to progress but it can result in lung cancer after a long time after the initial treatment. Treatment consists of surgical removal of the growth. Sometimes radiation and chemotherapy is performed. [7]

Related Research Articles

<span class="mw-page-title-main">Bartholin's gland</span> Mucous glands located near the vaginal opening

The Bartholin's glands are two pea sized compound alveolar glands located slightly posterior and to the left and right of the opening of the vagina. They secrete mucus to lubricate the vagina.

<span class="mw-page-title-main">Carcinoma</span> Malignancy that develops from epithelial cells

Carcinoma is a malignancy that develops from epithelial cells. Specifically, a carcinoma is a cancer that begins in a tissue that lines the inner or outer surfaces of the body, and that arises from cells originating in the endodermal, mesodermal or ectodermal germ layer during embryogenesis.

<span class="mw-page-title-main">Bartholin's cyst</span> Medical condition

A Bartholin's cyst occurs when a Bartholin's gland within the labia becomes blocked. Small cysts may result in minimal or no symptoms. Larger cysts may result in swelling on one side of the vaginal opening, as well as pain during sex or walking. If the cyst becomes infected, an abscess can occur, which is typically red and very painful. If there are no symptoms, no treatment is needed. Bartholin's cysts affect about 2% of women at some point in their life. They most commonly occur during childbearing years.

<span class="mw-page-title-main">Adenoid cystic carcinoma</span> Medical condition

Adenoid cystic carcinoma is a rare type of cancer that can exist in many different body sites. This tumor most often occurs in the salivary glands, but it can also be found in many anatomic sites, including the breast, lacrimal gland, lung, brain, Bartholin gland, trachea, and the paranasal sinuses.

<span class="mw-page-title-main">Cervical intraepithelial neoplasia</span> Medical condition

Cervical intraepithelial neoplasia (CIN), also known as cervical dysplasia, is the abnormal growth of cells on the surface of the cervix that could potentially lead to cervical cancer. More specifically, CIN refers to the potentially precancerous transformation of cells of the cervix.

<span class="mw-page-title-main">Extramammary Paget's disease</span> Medical condition

Extramammary Paget's disease (EMPD) is a rare and slow-growing malignancy which occurs within the epithelium and accounts for 6.5% of all Paget's disease. The clinical presentation of this disease is similar to the characteristics of mammary Paget's disease (MPD). However, unlike MPD, which occurs in large lactiferous ducts and then extends into the epidermis, EMPD originates in glandular regions rich in apocrine secretions outside the mammary glands. EMPD incidence is increasing by 3.2% every year, affecting hormonally-targeted tissues such as the vulva and scrotum. In women, 81.3% of EMPD cases are related to the vulva, while for men, 43.2% of the manifestations present at the scrotum.

<span class="mw-page-title-main">Vulvar cancer</span> Cancer involving the vulva

Vulvar cancer is a cancer of the vulva, the outer portion of the female genitals. It most commonly affects the labia majora. Less often, the labia minora, clitoris, or Bartholin's glands are affected. Symptoms include a lump, itchiness, changes in the skin, or bleeding from the vulva.

Vaginal cancer is an extraordinarily rare form of cancer that develops in the tissue of the vagina. Primary vaginal cancer originates from the vaginal tissue – most frequently squamous cell carcinoma, but primary vaginal adenocarcinoma, sarcoma, and melanoma have also been reported – while secondary vaginal cancer involves the metastasis of a cancer that originated in a different part of the body. Secondary vaginal cancer is more common. Signs of vaginal cancer may include abnormal vaginal bleeding, dysuria, tenesmus, or pelvic pain, though as many as 20% of women diagnosed with vaginal cancer are asymptomatic at the time of diagnosis. Vaginal cancer occurs more frequently in women over age 50, and the mean age of diagnosis of vaginal cancer is 60 years. It often can be cured if found and treated in early stages. Surgery alone or surgery combined with pelvic radiation is typically used to treat vaginal cancer.

<span class="mw-page-title-main">Papillary hidradenoma</span> Medical condition

A papillary hidradenoma, also termed hidradenoma papilliferum or mammary-like gland adenoma of the vulva, is a rare, but nonetheless most common benign tumor that occurs in and between anal and genital regions of females. These hidradenomas are sharply circumscribed, nodular tumors that usually develop in women's anogenital area but uncommonly occur in other sites in women and men. Papillary hidradenomas that develop outside of the anogenital region are termed ecctopic papillary hidradenomas or ectopic hidradenoma papilliferums.

<span class="mw-page-title-main">Salivary gland tumour</span> Medical condition

Salivary gland tumours, also known as mucous gland adenomas or neoplasms, are tumours that form in the tissues of salivary glands. The salivary glands are classified as major or minor. The major salivary glands consist of the parotid, submandibular, and sublingual glands. The minor salivary glands consist of 800 to 1000 small mucus-secreting glands located throughout the lining of the oral cavity. Patients with these types of tumours may be asymptomatic.

<span class="mw-page-title-main">Spiradenoma</span> Medical condition

Spiradenomas (SA) are rare, benign cutaneous adnexal tumors that may progress to become their malignant counterparts, i.e. spiradenocarcinomas (SAC). Cutaneous adnexal tumors are a group of skin tumors consisting of tissues that have differentiated towards one of the four primary adnexal structures found in normal skin: hair follicles, sebaceous sweat glands, apocrine sweat glands, and eccrine sweat glands. SA and SAC tumors were regarded as eccrine gland tumors and termed eccrine spiradenomas and eccrine spiradenocarcinomas, respectively. However, more recent studies have found them to be hair follicle tumors and commonly term them spiradenomas and spiradenocarcinomas, respectively. Further confusing the situation, SA-like and SAC-like tumors are also 1) manifestations of the inherited disorder, CYLD cutaneous syndrome (CCS), and 2) have repeatedly been confused with an entirely different tumor, adenoid cystic carcinomas of the salivary gland. Here, SA and SAC are strictly defined as sporadic hair follicle tumors that do not include the hereditary CCS spiradenomas and heridtary spiradenocarcinoms of CCS or the adenoid cystic carcinomas.

<span class="mw-page-title-main">Vulva</span> External genitalia of the female mammal

In mammals, the vulva consists of the external female genitalia. The human vulva includes the mons pubis, labia majora, labia minora, clitoris, vestibular bulbs, vulval vestibule, urinary meatus, the vaginal opening, hymen, and Bartholin's and Skene's vestibular glands. The urinary meatus is also included as it opens into the vulval vestibule. Other features of the vulva include the pudendal cleft, sebaceous glands, the urogenital triangle, and pubic hair. The vulva includes the entrance to the vagina, which leads to the uterus, and provides a double layer of protection for this by the folds of the outer and inner labia. Pelvic floor muscles support the structures of the vulva. Other muscles of the urogenital triangle also give support.

Cervical cancer staging is the assessment of cervical cancer to determine the extent of the disease. This is important for determining disease prognosis and treatment. Cancer staging generally runs from stage 0, which is pre-cancerous or non-invasive, to stage IV, in which the cancer has spread throughout a significant part of the body.

Salivary gland–like carcinomas of the lung generally refers a class of rare cancers that arise from the uncontrolled cell division (mitosis) of mutated cancer stem cells in lung tissue. They take their name partly from the appearance of their abnormal cells, whose structure and features closely resemble those of cancers that form in the major salivary glands of the head and neck. Carcinoma is a term for malignant neoplasms derived from cells of epithelial lineage, and/or that exhibit cytological or tissue architectural features characteristically found in epithelial cells.

<span class="mw-page-title-main">Ceruminous adenocarcinoma</span> Medical condition

Ceruminous adenocarcinoma is a malignant neoplasm derived from ceruminous glands of the external auditory canal. This tumor is rare, with several names used in the past. Synonyms have included cylindroma, ceruminoma, ceruminous adenocarcinoma, not otherwise specified (NOS), ceruminous adenoid cystic carcinoma (ACC), and ceruminous mucoepidermoid carcinoma.

Lymphatogenous metastasis is the spread of cancer from the vulva, clitoris and Bartholin glands. As these other more superficial cancers grow deeper into the surrounding tissue, the risk of lymphatogenous metastasis increases. Vulvar cancers spread primarily to the inguinofemoral lymph nodes. From these lymph nodes, cancer can spread to the pelvic lymph nodes.

Vaginal melanoma is a rare malignancy that originates from melanocytes in the vaginal epithelium. It is also known as a melanocytic tumor or as a malignant melanoma. It is aggressive and infrequently cured. The median overall survival is 16 months. Vaginal melanoma accounts 5.5% of all vaginal cancers and only 1% of all melanomas diagnosed in women. Vaginal melanomas are frequently diagnosed in advanced stages of the disease. The prognosis is poor and the most important risk factor is the presence of lymph node metastases.

<span class="mw-page-title-main">Vaginal cysts</span> Benign growths of the vaginal epithelium

Vaginal cysts are uncommon benign cysts that develop in the vaginal wall. The type of epithelial tissue lining a cyst is used to classify these growths. They can be congenital. They can present in childhood and adulthood. The most common type is the squamous inclusion cyst. It develops within vaginal tissue present at the site of an episiotomy or other vaginal surgical sites. In most instances they do not cause symptoms and present with few or no complications. A vaginal cyst can develop on the surface of the vaginal epithelium or in deeper layers. Often, they are found by the woman herself and as an incidental finding during a routine pelvic examination. Vaginal cysts can mimic other structures that protrude from the vagina such as a rectocele and cystocele. Some cysts can be distinguished visually but most will need a biopsy to determine the type. Vaginal cysts can vary in size and can grow as large as 7 cm. Other cysts can be present on the vaginal wall though mostly these can be differentiated. Vaginal cysts can often be palpated (felt) by a clinician. Vaginal cysts are one type of vaginal mass, others include cancers and tumors. The prevalence of vaginal cysts is uncertain since many go unreported but it is estimated that 1 out of 200 women have a vaginal cyst. Vaginal cysts may initially be discovered during pregnancy and childbirth. These are then treated to provide an unobstructed delivery of the infant. Growths that originate from the urethra and other tissue can present as cysts of the vagina.

Vulvar tumors are those neoplasms of the vulva. Vulvar and vaginal neoplasms make up a small percentage (3%) of female genital cancers. They can be benign or malignant. Vulvar neoplasms are divided into cystic or solid lesions and other mixed types. Vulvar cancers are those malignant neoplasms that originate from vulvar epithelium, while vulvar sarcomas develop from non-epithelial cells such as bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Epithelial and mesenchymal tissue are the origin of vulvar tumors.

References

  1. "Bartholin's gland carcinoma". Wikidata. Retrieved 2016-06-14.
  2. 1 2 3 4 5 6 7 8 WHO Classification of Tumours Editorial Board, ed. (2020). "10. Tumours of the vulva: Bartholin gland carcinoma". Female genital tumours: WHO Classification of Tumours. Vol. 4 (5th ed.). Lyon (France): International Agency for Research on Cancer. p. 442. ISBN   978-92-832-4504-9.
  3. 1 2 Broach, Vance; Lawson, Barrett (2022). "Chapter 18 - Bartholin gland carcinomas". In Frumovitz, Michael; Leitao, Mario M. Jr.; Preetha, Ramalingam (eds.). Diagnosis and Treatment of Rare Gynecologic Cancers. Amsterdam: Elsevier. pp. 305–314. ISBN   978-0-323-82938-0.
  4. 1 2 3 4 Heller, Debra S.; Bean, Sarah (2014). "Lesions of the Bartholin Gland". Journal of Lower Genital Tract Disease. 18 (4): 351–357. doi:10.1097/LGT.0000000000000016. ISSN   1089-2591. PMID   24914884.
  5. Di Donato, Violante; Casorelli, Assunta; Bardhi, Erlisa; Vena, Flaminia; Marchetti, Claudia; Muzii, Ludovico; Panici, Pierluigi Benedetti (2017). "Bartholin gland cancer". Critical Reviews in Oncology/Hematology. 117: 1–11. doi:10.1016/j.critrevonc.2017.06.005. PMID   28807231.
  6. Clinical gynecologic oncology, Philip DiSaia, editor. Chapter 8, Invasive Cancer of the Vulva, Jeanne M. Schilder, and Frederick B. Stehman. Pages 219-244. Elsevier/Saunders.(2012). ISBN   978-0-323-07419-3; Access provided by the University of Pittsburgh.
  7. Clinical gynecologic oncology, Phillip Saia, editor. Chapter 8, Invasive Cancer of the Vulva, Jeanne M. Schilder, and Frederick B. Stehman. Pages 219-244. Elsevier/Saunders.(2012). ISBN   978-0-323-07419-3; Access provided by the University of Pittsburgh.