Margin status had been proven in systemic reviews to be the most important factor for survival., Modern imaging does not accurately identify local extensions of microscopic disease and is inadequate for preoperative planning of the extent of resection. Magrina and Stanhope  proposed the subclassification of the exenteration groups into Type I (supralevator), Type II (infralevator), and Type III (with vulvectomy
), which has been helpful in facilitating an understanding of the extent of resection of the pelvic structures and the anatomical changes associated with each operation.
I referred the patient to a gynecologic oncologist, who performed a simple vulvectomy
. There were extensive foci of vulvar intraepithelial neoplasia 3.
Although it is known that gynecologic cancer patients' sexual functions are affected by the side effects of the treatment they have received and structural-physiological changes in genital organs, health care professionals generally fail to recognize these patients' sexual needs.8 Diagnosis of gynecologic cancer and surgical procedures such as radical hysterectomy and vulvectomy
, as well as treatments such as brachytherapy, radiotherapy and chemotherapy,cause significant health problems affecting a woman's body image, self-respect and sex life with her partner.21,22 It was stated in one study that a women's sex life is affected by 25% in breast cancers and 80% in gynecologic cancers.23
One case in Stage IA received vulvar reconstruction after an anterior vulvectomy
due to her large tumor size of 5 x 5 cm.
Treatment of early-stage vulvar cancer was mainly surgical, including vulvectomy
or radical local excision of the vulvar tumour and inguinofemoral lymphadenectomy.
A radical vulvectomy
with bilateral inguinofemoral lymph node dissection was performed later.
Therapy is wide excision or vulvectomy
. In tumours thicker than 1 mm, sentinel node examination is recommended.
In all described villoglandular mucinous adenocarcinomas of vulva [1-12], the clinical behavior of this rare malignant neoplasm seems to be rather indolent, and patients are generally doing well, after either radical vulvectomy
or wide local excision.
Surgical management options included radical vulvectomy
(RV), simple vulvectomy
(SV), hemivulvectomy (HV), and wide local excisions (WLE) with or without unilateral/bilateral inguinofemoral node dissections and iliac node dissections as required.
Corney, Crowther and Everett (1993) indicated that sexual dysfunctions are common among women who have had a radical hysterectomy and vulvectomy
operation, and this situation continues to be a chronic problem.
Unilateral carcinomas of the vulva can be treated with limited radical vulvectomy
and ipsilateral inguinal femoral node dissection.
With any treatment, however, patients and physicians should be aware of the risk of recurrence; for vulvectomy
, partial vulvectomy
, local excision, and laser ablation, recurrences were seen at rates of 19%, 18%, 22%, and 23%, respectively, in a review of 3,322 patients.