Bartholin gland carcinoma

Bartholin gland carcinoma is a type of cancer of the vulva arising in the Bartholin gland.[2] It typically presents with a painless mass at one side of the vaginal opening in a female of middle-age and older, and can appear similar to a Bartholin cyst.[2] The mass may be big or small, may be deep under skin or appear nearer the surface with overlying ulceration.[2] Average age at presentation is 53-years.[3]

Bartholin gland carcinoma
Other namesBartholin's gland cancer, Bartholin's gland carcinoma (morphologic abnormality), carcinoma of Bartholin's gland (disorder)[1]
Barthlin carcinoma tissue cross section
SpecialtyOncology, gynecology
SymptomsPainless soft swelling at one side of the vaginal opening[2]
Usual onsetTypically in the 50s[3]
CausesUnknown[2]
FrequencyRare, <1% of all female genital tract cancer, <5% of vulvar cancer[2]

The tumor can become large before a woman is aware of symptoms. One of the first symptoms can be painful sex. In other instances there may be a mass or ulcer in the vulva area. Many clinicians assume that an enlarged Bartholin gland is malignant in postmenopausal woman until proven otherwise. The growth of the tumor can spread to nearby areas such as the ischiorectal fossa and inguinal lymph nodes. Approximately 50% of bartholin gland carcinomas originate from squamous cell carcinomas. Another uncommon characteristic of Bartholin gland malignancies is that the growth of a lesion originates from the three types of epithelial tissue present in the gland: mucinous, transitional, and squamous.[4]

It is rare, accounts for less then 1% of all female genital tract cancer and less than 5% of all vulva cancer.[2]

Cause

The cause is unknown.[2]

Diagnosis

Bartholin gland can be differentiated by histology to determine whether the malignancy is due to squamous cell carcinoma, adenoid cystic carcinoma, or adenocarcinomas.[5]

Management

Though Bartholin gland carcinoma is rare, along with other unusual Bartholin gland growths, it many not be the typical practice for clinicians to consider lesions malignant. Early diagnosis can help to prevent the cancer from the glands to surrounding. Though malignancies of the Bartholin gland are rare clinicians biopsy Bartholin gland lesions in older women or when the growth reoccurs or does not respond to original treatment.[4]

Prognosis

The prognosis is optimistic as long as the growth has not metastasized to the lymph nodes.[4]

History

Bartholin glands were described in cattle by Casper Barthlin in 1677. Their existence in humans was postulated at that time.[4] Treatment can be a vulvectomy that results in the removal of the growth along with an extensive removal of adjacent tissue. An inguinal lymphadenectomy often accompanies the vulvectomy. The tissue that is removed sometimes includes sections of the vagina and rectum.[6]

Illustration of Bartholin glands vaginal abscesses.

The Adenoid cystic carcinoma of the Bartholin gland is another uncommon malignancy with symptoms that include local painful intermittent recurrences. The disease is slow to progress but it can result in lung cancer after a long time after the initial treatment. Treatment consists of surgical removal of the growth. Sometimes radiation and chemotherapy is performed.[7]

References
  1. "Bartholin's gland carcinoma". Wikidata. Retrieved 2016-06-14.
  2. WHO Classification of Tumours Editorial Board, ed. (2020). "10. Tumours of the vulva: Bartholin gland carcinoma". Female genital tumours: WHO Classification of Tumours. Vol. 4 (5th ed.). Lyon (France): International Agency for Research on Cancer. p. 442. ISBN 978-92-832-4504-9.
  3. Broach, Vance; Lawson, Barrett (2022). "Chapter 18 - Bartholin gland carcinomas". In Frumovitz, Michael; Leitao, Mario M. Jr.; Preetha, Ramalingam (eds.). Diagnosis and Treatment of Rare Gynecologic Cancers. Amsterdam: Elsevier. pp. 305–314. ISBN 978-0-323-82938-0.
  4. Heller, Debra S.; Bean, Sarah (2014). "Lesions of the Bartholin Gland". Journal of Lower Genital Tract Disease. 18 (4): 351–357. doi:10.1097/LGT.0000000000000016. ISSN 1089-2591. PMID 24914884.
  5. Di Donato, Violante; Casorelli, Assunta; Bardhi, Erlisa; Vena, Flaminia; Marchetti, Claudia; Muzii, Ludovico; Panici, Pierluigi Benedetti (2017). "Bartholin gland cancer". Critical Reviews in Oncology/Hematology. 117: 1–11. doi:10.1016/j.critrevonc.2017.06.005. PMID 28807231.
  6. Clinical gynecologic oncology, Philip DiSaia, editor. Chapter 8, Invasive Cancer of the Vulva, Jeanne M. Schilder, and Frederick B. Stehman. Pages 219-244. Elsevier/Saunders.(2012). ISBN 978-0-323-07419-3; Access provided by the University of Pittsburgh.
  7. Clinical gynecologic oncology, Phillip Saia, editor. Chapter 8, Invasive Cancer of the Vulva, Jeanne M. Schilder, and Frederick B. Stehman. Pages 219-244. Elsevier/Saunders.(2012). ISBN 978-0-323-07419-3; Access provided by the University of Pittsburgh.
  • Gynecologic Oncology Group an NIH-Funded research group that runs clinical trials
  • CancerNet an NIH database with clinical and scientific information
  • PubMed a search engine and database for Medical Literature
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