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Full labia minora reconstruction can be necessary due to congenital malformation or genetic syndromes, but more often is required following oncologic excisions, or debridements after vulvar or perineal infections. It is important to note that full labia reconstruction can be needed after genital mutilation, or iatrogenic deformity after previous labia reduction procedure. A 37-year-old female patient, with vulvar necrotizing fasciitis after a marsupialization of the right Bartholin's gland, was referred to the Gynecology and Obstetrics unit. Three surgical debridements were performed, associated with prolonged antibiotic therapy, leading to a total loss of the right labia minora and the clitoris glans, in addition to minimal loss of labia majora. With a two-stage approach on the labia minora, the first procedure allowed to pull the left labia minora as a labia sharing flap, in order to join the remnant scar tissue on the right side, respecting the anterior and posterior leaflets. The second part was performed five weeks later, after autonomization of the new labia minora flap. Once the flap was divided, a perfectly vascularized right neo-labia minora was obtained. The flap healed uneventfully. The patient was asked to complete a questionnaire at six months, which confirmed an excellent aesthetic result with a like with like reconstruction. Eight months later, a final correction was performed to enhance the definitive aesthetic aspect with lipofilling of the right labia majora. Two techniques have been previously published with a two-stage cross-labial transposition flap, one using a top cut leading to a bottom pedicle and another using a bottom cut with an upper pedicle. We proceeded with a one-time edge resection, respecting the full vascular pedicle and transposed the full height of the labia minora. This technique revealed to be extremely effective, guaranteeing a reliable vascularization and decreasing the risk of tearing on the pedicle. [ABSTRACT FROM AUTHOR]

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Concomitant with the rupture of the cloacal membrane, the perineal skin epithelium thickens (see accompanying article). In this study, we establish in female embryos and foetuses that the thick skin area divides into ventral and dorsal areas at ~14 weeks and gradually becomes restricted to the vaginal vestibule and anal canal thereafter. The dense mesenchymal core of the labia minora, which forms at ~8 weeks, extends dorsally to the anal canal as a midline reinforcement. The skin epithelium overlying this reinforcement is much thinner than the flanking ‘thick skin’, and is supported by an interrupted basement membrane, which implies epithelial–mesenchymal transformation of the thin midline epithelium and the subsequent establishment of the perineal raphe by the merging of the adjacent thick epithelium. Meanwhile, the anogenital distance in the perineum increases rapidly in length. Perhaps as a consequence, the labia minora cover only the ventral third of the vaginal vestibule at 20 weeks. The endodermal ducts of Bartholin's glands are identifiable at 7 weeks, while acini form at ~12 weeks. The vestibular bulbs become identifiable at ~10 weeks and form vascular networks after ~14.5 weeks. After the rupture of the cloacal membrane, the diameter of the junction of the dorsal cloaca with the anal canal is just a pinhole but widens dorsoventrally after the 7th week. The cutaneous muscles of the perineal area form as a ventrally open U‐shaped mesenchymal mass, from which the anal sphincter and bulbospongiosus muscle develop. In conclusion, our findings show that thick skin epithelium persists in the vaginal vestibule and anal canal. [ABSTRACT FROM AUTHOR]

• Bartholin gland carcinomas are rare, accounting for 5.8% of all vulvar cancers. • Misdiagnosis leads to significant diagnostic delays of up to 19 months. • Surgery was the preferred treatment modality for early-stage Bartholin gland carcinoma. • Primary chemoradiation ± surgical nodal assessment was favoured for stage II/III tumors. • Five-year recurrence free and overall survival were 76% and 64%, respectively. To evaluate the management and outcomes of Bartholin gland cancer at a single tertiary institution. A single institution retrospective review of 9 cases of BGC between 2004 and 2022 was conducted. Demographics, pathological characteristics, treatment, follow up and oncologic outcomes were extracted from clinical records. Data are summarised using descriptive statistics and survival probabilities are presented with Kaplan Meier graphs. Ten cases of BGC were identified at our institution over a period of 18 years. Nine out of ten clinical records were available for analysis. Eight patients presented with vulval swelling and four were treated initially for Bartholin cyst or abscess. One patient had a histological diagnosis of adenoid cystic carcinoma while the remaining were squamous cell carcinomas. With the exception of stage I disease chemoradiation was the primary mode of treatment. Adverse events included skin desquamation (4/9), venous thrombo-embolism (2/9), gastro-intestinal (1/9) and neurotoxicity (1/9). Median follow up was 60 months with a 5-year recurrence free and overall survival at 76 % and 64 % respectively. BGC may present after a long duration of symptoms and at advanced stages. Primary chemoradiation appears to be a feasible treatment option in advanced disease with the benefit of decreased morbidity. [ABSTRACT FROM AUTHOR]

Adenoid cystic carcinoma (AdCC) of the Bartholin's gland (AdCC-BG) is a very rare gynecologic vulvar malignancy. AdCC-BGs are slow-growing but locally aggressive and are associated with high recurrence rates. Here we sought to characterize the molecular underpinning of AdCC-BGs. AdCC-BGs (n = 6) were subjected to a combination of RNA-sequencing, targeted DNA-sequencing, reverse-transcription PCR, fluorescence in situ hybridization (FISH) and MYB immunohistochemistry (IHC). Clinicopathologic variables, somatic mutations, copy number alterations and chimeric transcripts were assessed. All six AdCC-BGs were biphasic, composed of ductal and myoepithelial cells. Akin to salivary gland and breast AdCCs, three AdCC-BGs had the MYB :: NFIB fusion gene with varying breakpoints, all of which were associated with MYB overexpression by IHC. Two AdCC-BGs were underpinned by MYBL1 fusion genes with different gene partners, including MYBL1 :: RAD51B and MYBL1 :: EWSR1 gene fusions, and showed MYB protein expression. Although the final AdCC-BG studied had MYB protein overexpression, no gene fusion was identified. AdCC-BGs harbored few additional somatic genetic alterations, and only few mutations in cancer-related genes were identified, including GNAQ , GNAS , KDM6A , AKT1 and BCL2 , none of which were recurrent. Two AdCC-BGs, both with a MYB :: NFIB fusion gene, developed metastatic disease. AdCC-BGs constitute a convergent phenotype, whereby activation of MYB or MYBL1 can be driven by the MYB :: NFIB fusion gene or MYBL1 rearrangements. Our observations further support the notion that AdCCs, irrespective of organ site, constitute a genotypic–phenotypic correlation. Assessment of MYB or MYBL1 rearrangements may be used as an ancillary marker for the diagnosis of AdCC-BGs. • Adenoid cystic carcinoma of the Bartholin's gland (AdCC-BG) is underpinned by MYB or MYBL1 fusion genes. • AdCC-BGs have few somatic genetic alterations in addition to the MYB/ MYBL1 fusion gene. • AdCC-BG constitutes a genotypic–phenotypic correlation. • MYB/ MYBL1 rearrangement assessment may be used as an ancillary marker for AdCC-BG diagnosis. [ABSTRACT FROM AUTHOR]

A variety of skin lesions from benign to premalignant and malignant can present on the vulva. One of the most common presentation to the emergency department is bartholin gland issues, from simple cyst to bartholin gland abscess and malignancy. Symptomatic Bartholin abscesses and cysts account for about 2% of all gynecologic visits per year [1] . Variety of management options are available for symptomatic bartholin cysts or abscesses, depends on the patient’s symptoms and degree of inflammation and infection present. Treatment options include simple drainage, fistulization, marsupialization, and excision of the gland. These treatment options do not guarantee complete cure of the bartholin gland abscess and they might be associated with rare complications. [2]. [ABSTRACT FROM AUTHOR]

Background: A Bartholin's gland abscess is one of the most common infections in women of reproductive age. Although Bartholin's gland abscesses have been reported in prepubertal children, they are rarer in prepubertal children than in adults. Herein, we report a case of bilateral Bartholin's gland abscesses in a 4-year-old girl with vitamin A deficiency. Case presentation: A 4-year-old girl diagnosed with autism spectrum disorder was admitted to the hospital for close examination and treatment because of persistent fever and malaise. The child was a marked fussy eater and was diagnosed with corneal ulceration and night blindness secondary to vitamin A deficiency. Both of the patient's labia were swollen, and a diagnosis of a bilateral Bartholin's gland abscess was made using computed tomography. Incisional drainage was performed under general anesthesia. The patient's postoperative course was uneventful, and she was discharged from the hospital on day 8 after the surgery. During hospitalization, attempts were made to correct the vitamin deficiency by adding nutritional supplements to the diet. Three months after the surgery, no recurrence of abscesses was noted. Conclusions: Decreased immunocompetence and mucosal barrier function due to vitamin A deficiency is thought to be the underlying cause of Bartholin's gland abscesses. Although prepubertal Bartholin's gland abscesses have been reported, they are rare. To the best of our knowledge, no reports of bilateral Bartholin's gland abscesses potentially caused by vitamin A deficiency have been reported. When prepubertal girls present with Bartholin's gland abscesses, the presence of immunodeficiency due to vitamin or trace element deficiency should also be considered. [ABSTRACT FROM AUTHOR]

Background/Aim: The Word catheter is a silicone device with a balloon system that may be inserted into a Bartholin's cyst or abscess in order to provide drainage and epithelization. The aim of this study was to evaluate the Word catheter as a therapy for Bartholin's cyst and abscess. Both patient and physician satisfaction, as well as the feasibility in an outpatient setting, were examined. Patients and Methods: A total of 51 women with a Bartholin's cyst or abscess were given the option of Word catheter insertion in an outpatient setting between August 2013 and March 2018. Both the patients and the consulting physicians were asked to complete two questionnaires, before, during and after treatment, with a view to evaluating the overall pain level, any discomfort symptoms and sexual activity, as well as satisfaction levels. Results: The insertion procedure seemed to constitute a short yet quite painful procedure. In most cases, the consulting physicians and the patients were content with the results. Nevertheless, dislodgement of the catheter or abscess recurrence were common. The removal of the Word catheter seemed to be short, painless, and uncomplicated. Most patients experienced pain and discomfort after catheter placement over the first days, with the symptoms fading over time. Sexual intercourse appeared to be negatively influenced. Conclusion: The Word catheter was frequently well tolerated for the treatment of Bartholin's cysts and abscesses, with few non-serious side-effects, however, it did interfere with sexual health. Nonetheless, it may not be possible to make general recommendations based on this exploratory study. [ABSTRACT FROM AUTHOR]

Introduction. Bartholin's gland abscesses are rare in pediatric patients, with limited documented cases. This case report aims to contribute valuable insights into managing this uncommon condition in children. Methods. A thorough examination and diagnostic workup were conducted on a 4-month-old female infant presenting with labial swelling. Clinical assessment strongly suggested the presence of a Bartholin's gland abscess. A culture of purulent discharge revealed the presence of Escherichia coli and Gram-negative Klebsiella pneumoniae. Antibiotic susceptibility testing guided the choice of treatment. Case Presentation. Despite initial treatment with oral antibiotics and sitz baths, there was limited therapeutic response. Close surveillance under the guidance of a pediatric surgeon continued for two months. Subsequently, surgical excision of the Bartholin gland was performed, and the specimen was sent for pathological examination. Results. Pathological analysis revealed signs of ulceration and granulation tissue, indicative of a mixed inflammatory response. An eight-month follow-up demonstrated marked improvement and overall well-being in the patient. Conclusion. This case report underscores the importance of considering Bartholin's gland abscess in diagnosing labial swelling in pediatric patients. The successful outcome achieved through surgical excision and appropriate antibiotic therapy provides valuable insights for potential treatment approaches in similar cases. Continued research and comprehensive studies are essential for establishing optimal treatment protocols for this patient demographic. [ABSTRACT FROM AUTHOR]

The adenoid cystic carcinoma (ACC) of Bartholin’s gland is a very rare tumor that usually grows aggressively due to perineural invasion. Although there is no guideline for the treatment due to the small number of patients, the primary treatment is considered as surgery. Adjuvant radiotherapy has also been shown to be beneficial. Three cases, which were histopathologically confirmed as ACC of Bartholin’s gland and received adjuvant radiotherapy treatment, were presented in this study. [ABSTRACT FROM AUTHOR]

Background: Aggressive angiomyxoma (AA) is a rare and slow-growing tumor in the pelvic and perineal regions that might develop into other perineal structures. It can present variably, ranging from a painless mass to non-specific symptoms such as dyspareunia. Due to the high relapse rate, extensive tumoral resection is reasonably required to prevent recurrences. It is also commonly confused with other conditions such as lipomas, Bartholin's gland cysts, and hernias. Case Presentation: A 43-yr-old female diagnosed with AA 10 yr ago was evaluated as a consequence of the tumor recurrence. She presented rare manifestations of a giant and cystic pelvic mass involving pararectal and paravaginal tissue in front of the sacrum. Conclusion: Although AA is a rare and slow-growing tumor, close observation is recommended due to the high relapse rate. Furthermore, extensive tumoral resection and regular follow-up can reduce morbidity in these patients. [ABSTRACT FROM AUTHOR]

Bartholin gland cysts account for 2% of all gynecologic visits per year. Although the treatments for Bartholin gland cysts seem apparently simple, recurrent cysts as well as the differential diagnosis between simple cyst, abscess or malignant pathology can complicate the management for this apparent common problem. Bartholin gland disorders, such as cysts and abscesses, can significantly impact a woman’s quality of life, necessitating effective and lasting interventions. Starting from the standard conduct of authors in Bartholin gland cyst, the article aims to review the current therapeutic techniques and to present a case report of an approach based on the excision of the gland. [ABSTRACT FROM AUTHOR]

Background: Transgender women and transfeminine nonbinary individuals may pursue a vulvovaginoplasty to improve their gender dysphoria. The goal of this study was to design, implement, and evaluate an educational module to increase acute care nurses' clinical and cultural skills in the care of the transgender population after vulvovaginoplasty. Method: All nursing staff and patient care technicians working on a hospital unit caring for patients after vulvovaginoplasty attended a 4-hour educational module. Participants completed an anonymous pre- and postsurvey. Survey data were analyzed for significant change in the categories of knowledge, perceived competence, sexuality and gender beliefs, interpersonal comfort, and human value. Results: Significant improvement was noted in the categories of knowledge and perceived competence. Improvements were also noted in the categories of sexuality and gender beliefs and interpersonal comfort, but were not statistically significant. An insignificant decline in scores was noted in the category of human value. Conclusion: Increased knowledge about vulvovaginoplasty and informed, culturally safe care may improve the patient outcome and experience, and nurses may be more confident and comfortable delivering care for this population. This intervention may serve as an exemplar to other institutions that hope to offer gender care surgeries. [J Contin Educ Nurs. 2023;54(11):509–515.] [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the outcomes of Bartholin abscess or cyst surgery, silver nitrate therapy, and cyst or abscess excision in terms of recurrence, duration of the procedure, and healing times. The files of 100 patients treated in our hospital for Bartholin cysts or abscesses between March 2022 and December 2022 were reviewed retrospectively. The patients' demographic characteristics were recorded. Demographic data, the location and size of Bartholin abscesses, complaints at presentation, and cases with recurrence were noted. The patients were divided into three groups according to the treatment applied and were compared with one another, especially in terms of recurrence, operative time, and recovery time. Group 1 consisted of those who underwent drainage due to Bartholin cyst or abscess, Group 2 of those treated with silver nitrate, and Group 3 of those who underwent cyst excision. Recurrence was detected in 12 (40%) of the cases in Group 1. Relapsed cases were treated with silver nitrate. Recurrence was observed in only one patient in the group treated with silver nitrate (Group 2). Bartholin cyst excision was performed on that patient. Mean operation times were 2.80 min in Group 1, 4.40 min in Group 2, and 23 min in Group 3 (p=0.0001). Mean recovery times were 3.37±0.49 days in Group 1, 6.13±0.73 days in Group 2, and 13.70±2.09 days in Group 3 (p=0.0001). A comparison of the patients in all three groups revealed that the recurrence rate was higher in the group receiving abscess drainage. While recurrence was observed in only one patient in the silver nitrate group, no recurrence occurred in the cyst excision group (p<0.001). This study emphasizes that silver nitrate application is a simple practical method that can be performed using local anesthesia, and involving minimal scar tissue, a faster procedure time, and faster recovery. [ABSTRACT FROM AUTHOR]

Abstract Background Adenoid cystic carcinoma (ACC) in Bartholin’s gland is an uncommon malignant tumor. These tumors have a vague clinical feature, so they are diagnosed late and discovered at a high-level stage. Our case presented Three Recurrences and Three times Misdiagnosis of Adenoid Cystic Carcinoma (ACC). Case presentation We report a case of adenoid cystic carcinoma arising in Bartholin's gland of a 64-year-old female patient that appeared after three previous vulvar tumors were excised. The patient underwent bilateral radiotherapy which was performed on the perineum. Conclusion ACC of the vulvar sweat glands is prone to misdiagnosis and delay in both diagnosis and treatment. As seen in our case, it was misdiagnosed three times as Chondroid Syringoma. Further studies need to be conducted to better understand the tumor prognosis, and its optimal treatment options.

Adenoid cystic carcinoma of the Bartholin's gland (ACCBG) is a rare, slowly but aggressive malignancy. We reported the case of a 31-year-old woman who was treated by local excision and then hemi-vulvectomy, with positive margins and perineural invasion. Radiation therapy (RT) was then performed delivering 45 Gy in 25 fractions in bilateral inguinal lymph nodes and 64.8 Gy in 36 fractions on the vulvar area. After 30 months, there was no local relapse (LR) but the patient presented a histologically documented lung recurrence. Genomic profiling of the tumor showed a MYB-NFIB fusion transcript and a somatic mutation of PLCG1. A treatment by Lenvatinib was started. We conducted a literature review of 100 published cases. Patients were mainly treated by radical vulvectomy (30%), hemi-vulvectomy (17%), wide or local excision (21% and 24%, respectively) or other. Forty-four percent of patients received postoperative RT, more frequently in case of positive margin (71.9% versus 29.5%). RT may reduce the risk of LR regardless of margin status, with 15.4% vs. 41.9% of LR with or without RT, respectively, in patients with negative margins, and 13% vs. 33.3% of LR with or without RT, respectively, in patients with positive margins. The risk of relapse of any type was 40.9% in patients who received adjuvant RT vs. 48.2% in patients who did not. Median time to relapse was 24 months (range 6–156 months). The most frequent metastatic sites were lung (76.7%) and bone (26.7%). Optimal treatment for ACCBG is still not clearly defined but pooling the data from published case report help us better understand this rare disease and help in the therapeutic decision. [ABSTRACT FROM AUTHOR]

Objective: Rare disease Background: Leiomyosarcomas of the vulva (VLMS) are very rare among gynecological malignancies, with a lack of knowledge on clinical presentation, prognosis, and therapeutic management. Case Reports: The database of the German Clinical Center of Competence for Genital Sarcomas and Mixed Tumors in Greifswald (DKSM) was reviewed between the years 2010 and 2020. A total of 8 cases of VLMS were retrieved and analyzed retrospectively. One exemplary case of VLMS was outlined in detail: A 45-year-old premenopausal woman presented with increasing vulvar swelling and discomfort. Given the suspicion of a Bartholin's gland abscess, the mass was excised. Final pathology revealed a solid tumor consistent with a moderately differentiated leiomyosarcoma of the vulva. A wide local excision was subsequently performed followed by adjuvant external beam radiation. The clinical features of these 8 cases of VLMS were compared to 26 cases of VLMS found in a review of the literature and to a total of 276 cases of uterine leiomyosarcoma (ULMS) from the same database (DKSM). Conclusions: In addition to rapid growth, observed in both tumor entities, VLMS most commonly presented as Bartholin's gland abscess or cyst and ULMS as leiomyoma. In this cohort, the prognosis of VLMS was much better than that of ULMS, most probably due to the significantly smaller tumor size of VLMS at diagnosis. Further data and larger studies on VLMS are needed to calculate recurrence and survival rates more accurately and define the role of adjuvant radiotherapy. [ABSTRACT FROM AUTHOR]

Background: Sneathia amnii is a conditional pathogen of the female genital tract that is involved in bacterial vaginosis and poor reproductive and perinatal outcomes. Few studies have reported subcutaneous cysts following invasive infection caused by S amnii. Case presentation: Here we report the case of a 27-year-old woman who presented with Bartholin's gland cyst due to S amnii infection, and was successfully treated with surgical neostomy and antibiotic agents. The isolate was gram-negative, bacillary, anaerobic, and was identified by polymerase chain reaction (PCR) amplification of the 16 S rRNA. Conclusions: S amni is an important but underappreciated pathogen that needs further investigation. This report describes the microbial and pathogenic characteristics of S amnii and is expected to provide a valuable reference in obstetric and gynecologic clinical practice. [ABSTRACT FROM AUTHOR]

To our knowledge, this is the first reported case of synchronous ovarian and vulva (Bartholin gland) cancer. A postmenopausal woman presented with a complex multiloculated left adnexal mass and 2‐cm right Bartholin gland mass. CA 125 was 59 IU/mL. Computed tomography of chest, abdomen, and pelvis showed a very large (32 × 13.5 × 22.5 cm) complex mass arising from the pelvis and extending to the level of the T12/L1 disk space. A right Bartholin mass with suspicious right inguinal nodes was seen. Midline laparotomy, total abdominal hysterectomy, bilateral salpingo‐oophrectomy, infracolic omentectomy, pelvic peritoneal biopsies, and peritoneal washings were carried out. Wide local excision of the right Bartholin gland mass was carried out in the same setting. Histopathology came back as Stage 2B left ovarian clear‐cell carcinoma and synchronous right Bartholin gland adenoid cystic carcinoma with lymphovascular invasion, incompletely excised, staged at least FIGO Stage 1B. Following local multidisciplinary team discussion and positron emission tomography scan review, the local committee agreed to start three cycles of adjuvant chemotherapy then proceed with Bartholin gland scar re‐excision and bilateral groin lymph node dissection. After the three cycles, the groin lymph nodes came back as metastatic adenocarcinoma with overall morphologic and immunohistochemical features consistent with metastatic ovarian clear‐cell carcinoma. Postoperative adjuvant chemotherapy was given. Initial follow‐up period over 9 months was uneventful. Synopsis: A first report on the management of synchronous ovarian and Bartholin gland carcinomas. [ABSTRACT FROM AUTHOR]

A 30-year-old nulligravida woman presented to the gynaecology outpatient department, with the chief complaint of progressive, painless swelling in the perineal region for the last three months. The swelling was initially asymptomatic, but for the previous 15 days, it had started to protrude out on straining and caused difficulty during urination and defecation. There was no associated pain or fever. Her menstrual cycles were regular, and she had no dysmenorrhea, dyspareunia or chronic pelvic pain. On local examination, there was a boggy, non-tender swelling of 3x2 cm just inside the introitus, on the left side, located in the subcutaneous tissue of the labia majora, at the junction of upper two-thirds and lower one-third. The patient also complained of a similar swelling at the same site six months earlier, which was tense, painful and associated with fever. At that time, it ruptured spontaneously with the discharge of foul-smelling purulent fluid. A clinical diagnosis of Bartholin cyst was made, and the cyst was completely excised. Of note, the cyst had a thick wall and was densely adherent to the underlying structures. The bed was very vascular, leading to a blood loss of approximately 250 mL during excision, which was quite unusual for a Bartholin cyst. The post-operative period was uneventful. A one-month follow-up visit showed complete healing of the surgical scar, and the patient was symptom-free. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the outcome and toxicity of brachytherapy in the treatment of primary vaginal cancer. In a retrospective analysis, 38 patients underwent treatment for vaginal carcinoma, and 4 were treated for carcinoma of Bartholin's gland using brachytherapy between 2010 and 2023. External beam radiation therapy (EBRT) was administered to 41 out of 42 patients, with a median dose of 45 Gy in 25 fractions. Concurrent chemotherapy was used in 29 patients. Endocavitary (3 single channel and 3 multichannel) brachytherapy alone was utilized in 6 of the 42 patients while 36 received interstitial brachytherapy. Most patients had a combination of vaginal cylinder and interstitial catheters, inserted under Transrectal Ultrasound (TRUS) and/or Transvaginal Ultrasound (TVUS) guidance. Brachytherapy planning was based on CT with MRI fusion. We used Inverse Planning Simulated Annealing (IPSA) to plan all cases and a class solution was developed to minimize high-dose points in the vaginal mucosa while maintaining the majority of the high dose inside the cylinder. Acute (<6 months) and late genitourinary (GU), gastrointestinal (GI), and vaginal toxicities were assessed using the Common Terminology Criteria for Adverse Events version 5 (CTCAE v5). Local control (LC), metastatic disease-free survival (mDFS), and overall survival (OS) were analyzed through Kaplan-Meier survival curves. The mean age was 68.9 years old, with a median follow-up of 50.5 months (3-168 months). 30 patients had squamous cell carcinoma (SCC), 6 adenocarcinoma, 3 clear cell carcinomas, 1 melanoma, and 2 gastric-type adenocarcinomas. FIGO stages was as follow: I (10%), II (71%), III (12%) and IV (7%). LC rates at 3 and 5 years were 86% and 82%, mDFS rates were 84% and 80%, and OS rates were 80.6% and 67.2%, respectively. When limited to SCC only, LC rates at 3 and 5 years were 92.2% and 92.2%, mDFS rates were 83.8% and 78.8%, and OS rates were 77% and 72%, respectively. Only 6 local relapses were recorded, with no late G3-4 GU/GI toxicity reported. Acute and late G3 vaginal toxicity (stenosis) occurred in 19% and 35% of patients, respectively. Three cases of vaginal necrosis and 2 suspicions of fistula were reported. 2 cases of vaginal necrosis were associated with local disease progression, except for one case where necrosis was limited and healed spontaneously. One patient required Hyperbaric Oxygen Therapy (HBOT). brachytherapy demonstrates excellent local control in primary vaginal cancer, particularly in SCC, with favorable toxicity profile. Only mild GU and GI toxicities were observed. We observed G3 vaginal stenosis in a third of our patients and necrosis in the absence of disease progression in only 1 patient. [ABSTRACT FROM AUTHOR]

This document is a collection of four case studies in gynaecological pathology. The first case study discusses a rare example of lymphoepithelial-like carcinoma (LELC) of the cervix that is not associated with human papillomavirus (HPV) or Epstein-Barr virus (EBV) infection. The second case study focuses on pilomatrix-like high grade endometrioid carcinoma (PiMHEC), a rare and aggressive gynaecologic neoplasm. The third case study highlights the occurrence of pleomorphic adenoma in the vulva, a rare diagnosis that can have clinical implications. The fourth case study examines the histopathological findings in amoebic cervicitis, a rare manifestation of extra-intestinal amoebiasis that mimics cervical carcinoma. These case studies contribute to our understanding of these uncommon gynaecological conditions and emphasize the importance of accurate diagnosis for appropriate treatment. [Extracted from the article]

Background: Adenoid cystic carcinoma (ACC) in Bartholin's gland is an uncommon malignant tumor. These tumors have a vague clinical feature, so they are diagnosed late and discovered at a high-level stage. Our case presented Three Recurrences and Three times Misdiagnosis of Adenoid Cystic Carcinoma (ACC). Case presentation: We report a case of adenoid cystic carcinoma arising in Bartholin's gland of a 64-year-old female patient that appeared after three previous vulvar tumors were excised. The patient underwent bilateral radiotherapy which was performed on the perineum. Conclusion: ACC of the vulvar sweat glands is prone to misdiagnosis and delay in both diagnosis and treatment. As seen in our case, it was misdiagnosed three times as Chondroid Syringoma. Further studies need to be conducted to better understand the tumor prognosis, and its optimal treatment options. [ABSTRACT FROM AUTHOR]

Leiomyomas are uncommon vulvar neoplasms often misdiagnosed as other Bartholin gland pathology. This case report describes a case of accelerating growth of a vulvar mass, initially diagnosed as Bartholin cyst. Surgical excision led to a histopathologic diagnosis of vulvar leiomyoma. The postoperative recovery was complicated by secondary hematoma and dehiscence of the surgical site. There was no recurrence at 2 years follow‐up. [ABSTRACT FROM AUTHOR]

Introduction and purpose: Bartholin's glands are paired structures, playing a significant role in lubricating the vagina through the production of mucus. They are physiologically undetectable, but when their ducts are clogged, the accumulating secretion can lead to various pathologies. The most common are cysts and abscesses, the symptomatic conditions of which are the causes of nearly 2% of gynecological visits annually. Statistically, they most frequently occur in women of childbearing age, however, young age is not a rule. The aim of the study is to summarize the state of knowledge about Bartholin's gland cysts and abscesses, with an indication of the currently used therapies. State of knowledge: In some cases, the course of these pathologies can be asymptomatic, however, the rest of the patients may experience unpleasant symptoms and require treatment. During diagnostics, it is important to carefully collect an interview and conduct a physical examination, because in most cases on this basis it is possible to make an accurate diagnosis. However, in case of doubt, imaging tests can also be used. There may be times when patients with asymptomatic cysts may not require treatment. Nevertheless, choosing the right therapy is sometimes challenging for the clinician due to the potential risk of symptoms recurring. Conclusion: Although there are many different treatments available, the most commonly used appears to be marsupialization or incision and drainage with Word catheter placement. Additionally, an increasing number of articles devoted to the use of the CO2 laser can also be observed, but even it has its drawbacks. For this reason, there is still a need for further research into new methods of treatment that would ensure both good results and high comfort for the patients.

Aesthetic gynecologic surgery is gaining popularity among women and physicians. Aesthetic genital surgery for women encompasses both minimally invasive and open surgical procedures. Cosmetic genital procedures for women described in this article include perineoplasty, vaginoplasty, vaginal rejuvenation, labiaplasty, G-spot enlargement, Bartholin gland surgery, clitoral hoodoplasty, clitroplasty, hymenoplasty, and mons pubis plastic surgery. Based on a review of the literature for each procedure, the article discusses procedural methods and techniques, indications for implementation, potential consequences and side effects of the procedure, nursing implications, patients' motives for undergoing the procedure, and positions of scientific institutions relative to the procedure. [ABSTRACT FROM AUTHOR]

SOX10 is a novel marker of acinus and intercalated duct differentiation in salivary gland tumors: A clue to the histogenesis for tumor diagnosis. SOX10-positive salivary gland tumors: a growing list, including mammary analogue secretory carcinoma of the salivary gland, sialoblastoma, low-grade salivary duct carcinoma, basal cell adenoma/adenocarcinoma, and a subgroup of mucoepidermoid carcinoma. Because of the dual cell population present in this tumor, immunohistochemical evaluation demonstrates characteristic and generally reproducible findings. Keywords: Adenoid cystic carcinoma; Adnexal neoplasm; Molecular pathology EN Adenoid cystic carcinoma Adnexal neoplasm Molecular pathology 761 764 4 08/22/22 20220901 NES 220901 Primary cutaneous adenoid cystic carcinoma (PCAdCC) is a rare entity, with only 131 cases previously reported in the English literature, after exclusion of cases occurring in the periocular region and ear canal.1-8 As compared to its counterpart in salivary gland, it tends to follow a more indolent course, often with multiple recurrences.9,10 The majority of PCAdCCs are found in the head and neck region or trunk.1 Outside of the vulva, where adenoid cystic carcinoma of the Bartholin glands is a known entity, only rare cases have been reported in the genital or perineal areas.1,11 A 70-year-old man presented to the emergency department with a draining and ulcerated lesion on his scrotum. [Extracted from the article]

Objective: This study aim was to examine the success rate of simple needle aspiration for acute Bartholin's gland abscess and compare it to incision and drainage treatment.Study Design: This was a non-randomised prospective study conducted at the academic Hospital of La Conception, Marseille, France. We included 202 women who presented with acute Bartholin's gland abscess between June 2013 and October 2017. The study cohort was subdivided into two treatment groups, simple needle aspiration (134 women) or incision and drainage (42 women), according to the women's preference. Success was considered as the absence of surgical treatment within one year of the initial treatment.Results: The success rate was 68/134 (51% (95% CI: 42-59%)) in the simple needle aspiration group and 25/42 (60%) in the incision drainage group (RR: 0.85, 95% CI: 0.63-1.15, P = 0.3). Among 122/134 (91%) women who completed the satisfaction survey, 99/122 (81%) were satisfied with the simple needle aspiration.Conclusions: Simple needle aspiration can be offered as first-line treatment for acute Bartholin's gland abscess. Simple needle aspiration can be performed as an outpatient procedure without general anesthesia avoiding surgical treatment in half of the cases one-year post- simple needle aspiration. [ABSTRACT FROM AUTHOR]

Objective: Bartholin cysts or abscesses are observed in approximately 2% of women, usually in their reproductive years. Although none of the treatments appear to be superior, there are several options including drainage with basic incision, Word catheter application, marsupialization, silver nitrate application, and excision. The primary outcome in this study was to evaluate the recurrence rates in patients who underwent marsupialization or Word catheter for the treatment of Bartholin cyst or abscesses, and the secondary outcome was to evaluate the rates of patient satisfaction. Material and Methods: A total of 196 patients who underwent either Word catheterization or marsupialization for the treatment of Bartholin cyst or abscesses between 2014 and 2017 were included in this retrospective cohort study. The size and location of the cyst/abscess, the operation duration, and the recurrence was recorded. A 5-point visual analog scale (VAS) was used to assess patient satisfaction and whether patients would recommend their treatment to others. Results: Recurrence was observed in 11 (8.3%) patients in the marsupialization group, and 12 (18.8%) patients in the Word catheter group (p=0.034). Median (range) VAS scores in the marsupialization group were better than the Word catheter group [4 (1-5) vs 3 (1-5); p<0.001]. Conclusion: Higher recurrence rate and dissatisfaction level were found in the Word catheter group. The only advantage of using Word catheter was its short operation time. These results appear to show that marsupialization should be the first-line treatment for Bartholin cysts and abscesses. However, the small number of cases and the retrospective nature of this study mean that larger, prospective studies are required to support this hypothesis. [ABSTRACT FROM AUTHOR]

A 23-year-old woman presented to the gynaecology outpatient department with a left antero-lateral vaginal wall swelling. Clinical assessment was indicative of a Bartholin cyst. Histology revealed evidence of endometriosis following excision of the lesion. The patient had no other symptoms of endometriosis and remained asymptomatic. This case highlights the widespread locations of endometrial tissue and the range of symptomatology leads to diagnostic difficulty without histological confirmation. [ABSTRACT FROM AUTHOR]

Objective: Rare disease Background: Adenoid cystic carcinomas of Bartholin's gland are rare among gynecological malignancies, accounting for 0.1% to 7% of vulvar carcinomas and 0.001% of all female genital tract malignancies. There are no specific guidelines regarding treatment recommendations; therefore, they are commonly treated like vulvar cancer. Case Report: We present the case of a 42-year-old premenopausal woman with an adenoid cystic carcinoma of Bartholin's gland diagnosed upon biopsy of a palpable, predominantly vaginally located mass causing foreign-body sensation, vaginal pain, and extreme dyspareunia. The adenoid cystic carcinoma of Bartholin's gland was treated by radical resection in an extensive interdisciplinary surgical approach including bilateral inguinal lymph node dissection, partial posterior colpectomy, amputation of the rectum, and creation of a descendostomy, as well as reconstruction of the vagina and defect coverage using flap plastic. Conclusions: With the presentation of this case, we propose a possible therapeutic approach to adenoid cystic carcinomas of Bartholin's gland with emphasis on surgical management. Especially in young patients, we recommend primary radical surgery with the objective to obtain negative resection margins. However, additional data on the adenoid cystic carcinoma of Bartholin's gland is needed to better understand its biological behavior and thus optimize and standardize treatment. The role of systematic inguinal-femoral lymphadenectomy and adjuvant and neoadjuvant treatment modalities need further evaluation. [ABSTRACT FROM AUTHOR]

Abstract Background In this case report we present a case of endometriosis in the Bartholin gland without surgery in the perineal area. So far, only five cases concerning endometriosis in the Bartholin gland, which may or may not be an isolated finding, have been reported in the literature. Case presentation A 31-year-old Indo-surinamese woman with primary infertility presented at our out-patient clinic with cyclical vulvar pain. On gynecological examination, a cyst of 1 × 2 cm was found in the right gland of Bartholin. A transvaginal ultrasound revealed normal gynecological anatomy and did not reveal any contributing information. Due to the recurring pain of the cyst, surgery was scheduled. During surgery, the marsupialization of the cyst resulted in drainage of a chocolate-colored fluid. Pathological examination revealed stroma lined with non-typical columnar epithelium with hemosiderin pigments, which confirmed a diagnosis of endometriosis in the Bartholin gland. Conclusion Our findings revealed a case of endometriosis outside the pelvis, without any deep intraperitoneal involvement. So far, only five cases concerning endometriosis in the Bartholin gland, which may or may not be an isolated finding, have been reported in literature.

While uterine leiomyomas remain a common occurrence affecting nearly 30% of adult women above 35yo, leiomyomas can arise anywhere smooth muscle cells are located in the body. Vulvar leiomyomas are a particularly rare diagnosis, often misdiagnosed as Bartholin gland cyst, comprising 0.07% of vulvar tumors, and thought to arise from smooth muscle within the round ligament, erectile tissue, and dartos muscle. Even more rare is the presentation of vulvar leiomyoma in the adolescent population and family history of vulvar leiomyoma. We present the case of a 16yo girl who noticed a painless vulvar mass that had increased in size during the previous 7 months. Notably, the patient's mother reported having a history of recurrent vulvar leiomyoma requiring multiple surgical excisions. Single digit vaginal exam revealed a solid well-circumscribed vulvar mass that involved the right labia majora and perineum, extending caudally to the level of ischial spine. MRI showed a 9.6 × 9.1 × 7.2cm vulvar mass suggestive of leiomyoma that displaced rectum to the left (Figure 1). A multidisciplinary surgical procedure with pediatric gynecology and colorectal surgery was performed. A longitudinal skin incision was made lateral to the right labia majora and extended inferiorly onto right of midline of the perineum (Figure 2). The mass was excised in its entirety from within the pararectal space, and dead space closed in layers with interrupted sutures followed by skin closure. Final specimen was 12.2cm in diameter, weighing 319g. Pathology report noted smooth muscle bundles composed of spindle cells with positive staining for smooth muscle actin and desmin, consistent with benign leiomyoma. Patient admitted overnight with vaginal packing, which was removed after 24 hours and the patient discharged to home on post-op day one. There have been over 100 cases of vulvar leiomyomas reported with only 3 reported in adolescents. To our knowledge this is the first reported case have of familial vulvar leiomyoma. Though there are known syndromes of hereditary cutaneous leiomyomas, uterine fibroids, and renal cancer, no syndromes are known regarding inherited vulvar leiomyoma. In this case preoperative MRI was helpful for delineation of location of the mass, surgical planning and confirmation of clinical suspicion of leiomyoma given smooth muscle consistency on T2 weighted images. We opted for a paramedian skin incision rather than an incision at the mucocutaneous junction of the labia and vestibule often described in the literature to preserve the integrity of the vaginal canal. [ABSTRACT FROM AUTHOR]

Background Sexual history does not accurately identify those with extragenital Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT), so universal extragenital sampling is recommended. Nucleic acid amplification tests (NAATs) are expensive. If urogenital, plus rectal and pharyngeal, samples are analyzed, the diagnostic cost is trebled. Pooling samples into 1 NAAT container would cost the same as urogenital samples alone. We compared clinician triple samples analyzed individually with self-taken pooled samples for diagnostic accuracy, and cost, in men who have sex with men (MSM) and females. Methods This was a prospective, convenience sample in United Kingdom sexual health clinic. Randomized order of clinician and self-samples from pharynx, rectum, plus first-catch urine (FCU) in MSM and vulvovaginal swabs (VVS) in females, for NG and CT detection. Results Of 1793 participants (1284 females, 509 MSM), 116 had NG detected (75 urogenital, 83 rectum, 72 pharynx); 276 had CT detected (217 urogenital, 249 rectum, 63 pharynx). There was no difference in sensitivities between clinician triple samples and self-pooled specimens for NG (99.1% and 98.3%), but clinician samples analyzed individually identified 3% more chlamydia infections than pooled (99.3% and 96.0%; P  = .027). However, pooled specimens identified more infections than VVS/FCU alone. Pooled specimens missed 2 NG and 11 CT infections, whereas VVS/FCU missed 41 NG and 58 CT infections. Self-taken pooled specimens were the most cost-effective. Conclusions FCU/VVS testing alone missed many infections. Self-taken pooled samples were as sensitive as clinician triple samples for identifying NG, but clinician samples analyzed individually identified 3% more CT infections than pooled. The extragenital sampling was achievable at no additional diagnostic cost to the FCU/VVS. Clinical Trials Registration NCT02371109. [ABSTRACT FROM AUTHOR]

Copyright of Gaceta Médica de Caracas is the property of Academia Nacional de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article discusses a series of 60 cases of benign vulvar tumors. The study aimed to report the various types of benign tumors found in vulvar pathology. The tumors were diagnosed through clinical examination, dermoscopy, and biopsy. The study found that most tumors did not require treatment, but surgical excision was performed for aesthetic reasons or if malignancy was suspected. The article emphasizes the role of dermatologists in recognizing and diagnosing benign and malignant vulvar lesions. [Extracted from the article]

I Sir i : Although Bartholin's glands and minor vulval vestibular glands originate in the urogenital sinuses and are considered to be organs similar to the bulbourethral (Cowper's) and urethral (Littre's) glands in men, respectively, their immunohistochemical features have not been thoroughly investigated. Some lesions in the female genital tract that are NKX3.1 positive but PSA negative may be indicative of Bartholin and/or minor vestibular gland differentiation or metaplasia rather than prostatic differentiation. [Extracted from the article]

Objective: The data regarding microbiological and clinical characteristics of Bartholin gland abscesses during pregnancy is limited. Given the hormonal and physiological changes during pregnancy we aimed to examine whether a difference exists in the clinical and microbiological features of Bartholin's gland abscess during pregnancy and the puerperium as compared with nonpregnant patients. In addition, we aim to evaluate whether a Bartholin's gland abscess during pregnancy is associated with adverse pregnancy outcomes.Study Design: A retrospective cohort study was conducted, including all women with Bartholin's gland abscess who were treated surgically between the years 2009-2016 in the Soroka University Medical Center. Various demographic, clinical and microbiological characteristics were retrieved and a comparison was made between patients with a Bartholin's gland abscess during pregnancy and the puerperium (study group) as compared with nonpregnant patients (controls). In addition, obstetrical characteristics of patients in the study group were retrieved.Results: Of the 363 women who were treated surgically, 38 (10.5%) were in the study group. Women in the study group were significantly younger (26.8 versus 32.8 p < .001). No differences were found between the groups with regard to the clinical presentation (affected side, fever, leukocytosis and need for antimicrobial treatment) or the selected mode of drainage. In addition, no difference was found in the percentage of positive culture results, nor in the distribution of the pathogens between the groups, in both groups the most common pathogen was Escherichia coli. Yet, among the study group, recurrence of the abscess was more common (13.5 versus 2.15% p = -.067) as evident by significantly higher recurrent referrals to the emergency department and recurrent hospitalizations (28.9 versus 14.8%, p < .05, and 26.3 versus 8.0% p < .001, respectively). Of note, fever after the procedures, pain, discharge and bleeding did not differ significantly between groups. No cases of premature rupture of membranes or chorioamnionitis were noted following treatment.Conclusions: In our cohort, no differences were found between the study groups in the clinical presentation and microbiological features. A significantly higher recurrence rate was noted in the study group. Among pregnant patients no adverse perinatal outcomes were noted. [ABSTRACT FROM AUTHOR]