Radical vulvectomy and "sneak" superficial inguinal lymphadenectomy with a single elliptic incision.

With a single elliptic radical vulvectomy incision, resection of the primary tumor and bilateral superficial inguinal lymphadenectomies were performed in 18 patients with invasive squamous cell carcinoma of the vulva. Twelve patients (67%) had no morbidity from the procedure, while five patients (28%) developed significant wound breakdown and one patient (5%) developed a groin hematoma. For select patients with invasive vulvar cancer, this modification of the standard "butterfly" incision offers an acceptable surgical approach to this disease, allowing removal of the primary lesion and adequate sampling of the groin lymphatics. Results of pathologic examinations allow selection of those patients requiring further therapy.