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Chemo-surgical approach in vulvar leiomyosarcoma: A case report
Giuseppe Capalbo1, Alessandra Logoteta1, Roberta Gallo1
1Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Polyclinic Umberto I, Rome, Italy.
Tumori
|October 14, 2022
Summary
Primary vulvar leiomyosarcoma (LMS) is rare. Neoadjuvant chemotherapy followed by surgery offers a viable treatment option for bulky LMS, optimizing radical surgical possibilities and leading to disease-free survival.
Area of Science:
- Gynecologic Oncology
- Surgical Oncology
- Medical Oncology
Background:
- Primary vulvar sarcoma is a rare malignancy, accounting for 1%-3% of vulvar cancers.
- Leiomyosarcoma (LMS) is the most common histologic subtype of vulvar sarcoma.
- Limited evidence exists due to the rarity, with no established treatment guidelines or phase III trials.
Observation:
- A case of a 74-year-old woman with a large (12.5 cm) primary vulvar LMS is presented.
- The patient underwent neoadjuvant chemotherapy, achieving a partial response.
- This was followed by radical vulvectomy with V-F flap reconstruction and adjuvant chemotherapy.
Findings:
- Neoadjuvant chemotherapy facilitated downstaging of the vulvar lesion, optimizing surgical outcomes.
- The patient achieved negative surgical margins.
- One year post-treatment, the patient remained disease-free.
Implications:
- Neoadjuvant chemotherapy represents a potentially valuable therapeutic strategy for bulky vulvar sarcoma, enhancing surgical resectability.
- This case highlights the potential efficacy of a multimodal approach combining chemotherapy and surgery.
- Further collaborative studies are crucial to establish definitive treatment protocols for this rare condition.
