Bartholin gland carcinomas

Approximately 6000 women are diagnosed with vulvar cancer annually. Vulvar cancer is a rare disease accounting for 5% of all gynecologic malignancies. Among vulvar cancers, Bartholin gland carcinomas are rarer still, accounting for 1%–7% of all vulvar tumors and less than 1% of all gynecologic cancers. The Bartholin gland (also known as Bartholin’s gland, or greater vestibular gland) was first described by the Danish anatomist Caspar Bartholin in 1675 and has the normal function of providing vulvovaginal lubrication. The Bartholin glands and ducts are located bilaterally at approximately the 4 and 8 o’clock positions in the labia minora, with duct openings just proximal to the introitus, and with an approximate size of 0.5–1cm. Bartholin gland carcinomas occur in women with a median age of 53 years. The average tumor size at diagnosis is 39mm. Approximately 17% of all patients are diagnosed with stage I disease, and 28% are diagnosed with stage II disease. Approximately 32% of patients are found to have stage III disease, in which disease has reached the inguinofemoral lymph nodes. Approximately 23% of patients are diagnosed with stage IV disease. Among patients who undergo primary surgical treatment, 5-year survival ranges from 70% to 93%. Here, we present a clinical case of Bartholin gland carcinoma. We address the epidemiology, pathology, diagnosis, work-up, staging, prognostic factors, treatment of primary disease (including lymph node sampling, treatment of stage III or IV disease, postsurgical treatment, and surveillance for recurrence), survival, and patterns of failure for this rare gynecologic malignancy.