Rapid groin recurrence of a vulvar carcinoma with invasion of the femoral vessels and the importance of the initial groin dissection in the staging surgery.

BACKGROUND

Carcinoma of the vulva accounts for 3% to 5% of all gynaecological malignancies. The disease spreads from the vulva through embolization to the locoregional lymphatic station, the inguinofemoral nodes. The single most important prognostic factor is the presence or absence of nodal disease.

CASE REPORT: A 56-year old woman was admitted with a large, centrally necrotic left groin recurrence of a vulvar carcinoma. One year previously, she had undergone a radical vulvectomy without groin dissection for a pT2 vulvar carcinoma. In our institution, the tumour mass was excised. The femoral vein was completely thrombosed and invaded by the neoplastic recurrence.

CONCLUSION

Groin recurrence of vulvar carcinoma is a difficult therapeutic challenge and has a poor prognosis. In order to minimize complications, the inguinofemoral dissection should be performed except in stage 1A (FIGO) with stromal invasion not greater than 1 mm.