Complete Pathological Response in Stage IVA Human Papillomavirus-Associated Squamous Cell Carcinoma of Bartholin’s Gland Treated with Primary Chemotherapy: A Case Report
Diana Mutusamy *
Department of Obstetrics and Gynaecology, Hospital Tuanku Jaafar, Seremban, Malaysia.
Mohamad Faiz Mohamed Jamli
Department of Obstetrics and Gynaecology, Hospital Tuanku Jaafar, Seremban, Malaysia.
Noor Azura Noor Mohamad
Department of Obstetrics and Gynaecology, University Teknologi MARA, Sungai Buloh, Malaysia.
Manisah Mohd Zin
Department of Pathology, Hospital Tuanku Jaafar, Seremban, Malaysia.
*Author to whom correspondence should be addressed.
Abstract
Aims: Bartholin’s gland carcinoma (BGC) is an uncommon vulvar malignancy. We aim to describe successful treatment of stage IVA squamous cell carcinoma of Bartholin’s gland with primary chemotherapy.
Presentation of Case: A 52-year-old postmenopausal woman presented with right-sided painless vulvar mass of 6 months duration. Examination revealed a 12 cm fixed lesion involving right Bartholin’s gland extending to the rectum. MRI pelvis demonstrated tumor encroaching towards anorectal junction with possible anal sphincter involvement. Biopsy of rectal mass and Bartholin’s gland mass confirmed non-keratinizing squamous cell carcinoma of Bartholin’s gland origin, with strong p16 immunopositivity consistent with HPV association. Interim clinical assessment after 3 cycles of paclitaxel 175 mg/m2 and carboplatin (AUC 6) showed marked tumor regression, with complete clinical response following completion of 6th cycle. Colonoscopy and biopsy of the rectal mucosal lesion post-treatment verified complete pathological response, characterized by absence of viable tumor cells and presence of extensive fibrosis.
Discussion and Conclusion: Primary chemotherapy is a successful treatment option in achieving complete pathological remission and allow for organ integrity preservation with sustained oncologic outcomes for stage IVA HPV-associated squamous-cell carcinoma of Bartholin’s gland.
Keywords: Bartholin’s gland carcinoma, chemotherapy, human papillomavirus, vulvar cancer