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Groin recurrence after micrometastasis in a sentinel lymph node in a patient with vulvar cancer
Karl F Tamussino1, Arnim A Bader, Sigurd F Lax
1Department of Obstetrics and Gynecology, University of Graz, Austria. karl.tamussino@kfunigraz.ac.at
Background:
The sentinel lymph node concept is attractive in vulvar cancer because of the potential to avoid the morbidity associated with formal groin dissection.
Case:
An 84-year-old patient with a T2 carcinoma of the anterior vulva underwent surgery including bilateral sentinel node excision after identification with technetium-labeled nanocolloid. Frozen section histology showed a tumor deposit <1 mm in diameter in a left groin node whereas four nodes in the right groin were apparently negative. Completion lymphadenectomy was performed only for the left groin. Final histology including serial sectioning showed a micrometastasis in one of seven nodes from the right groin; no further treatment was given. Sixteen months postoperatively the patient developed a recurrence in the right groin; the left groin was free of tumor.
Conclusion:
This case indicates that groins with a micrometastasis detected by sentinel lymph node excision require further treatment.