A Special Treatment of Vulvar Cancer with Pelvic Organ Prolapse: A Case Report

Abstract

\n Background: Pelvic organ prolapse is a common benign condition in women, defined as the descent of one or more of the following: anterior vaginal wall; posterior vaginal wall; uterus (cervix); and apex of the vagina (vaginal vault or cuff scar after hysterectomy). Vulvar cancer is uncommon, accounting for 2-5% of gynecologic malignancies. Vulvar cancer and pelvic organ prolapse tend to occur in elderly individuals with other complications, such as heart disease, hypertension and diabetes. Risk during the perioperative period is very high; therefore, gynecologists should provide the most appropriate and comprehensive treatment plan to achieve a good prognosis. Case presentation: The patient’s main concerns is vulva pruritus and vulva mass prolapse. Important clinical examinations include vulvar biopsy suggesting vulvar carcinoma, and the POP Quantification (POP-Q) scores showing Aa:+2, Ba:+2, C:0, D:0, Ap:+1, Bp:+1. The primary diagnoses is highly differentiated squamous cell carcinoma of the vulva, pelvic organ prolapse. The patient underwent extensive vulvotomy, vulvoplasty, partial urethrotomy, external urethroplasty, partial cervicectomy, anterior and posterior vaginal wall repair, sacrospinous ligament suspension, and laparoscopic bilateral inguinal lymph node dissection. The patient recovered well and was discharged from hospital. But unfortunately, the patient was followed-up via telephone and died 1 year after surgery. Conclusions: Vulvar cancer and pelvic organ prolapse tend to occur in elderly individuals with other complications, such as heart disease, hypertension and diabetes. Risk during the perioperative period is very high; therefore, gynecologists should provide the most appropriate and comprehensive treatment plan to achieve a good prognosis.