A multidisciplinary approach to fertility-sparing therapy for a rare vulvar tumor

Cary L. Dicken, Harry J. Lieman, Ashlesha K. Dayal, Subhakar Mutyala, Mark H. Einstein

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objective: Case report of a young woman with a rare vulvar malignancy who received treatment with a personalized multidisciplinary approach to balance management of her malignancy without compromising survival with her desire for future pregnancy. Design: Case report. Setting: University hospital. Patient(s): A 33-year-old woman, gravida 2, para 1-0-1-1, who had a diagnosis of synovial cell sarcoma of the vulva and who desired future fertility. Intervention(s): At multiple steps, treatment was planned to try to maximize fertility preservation without potentially affecting initial treatment, which included a radical hemivulvectomy with bilateral lymph node dissection, brachytherapy with interstitial needles (20 Gy), and external beam radiation therapy (50 Gy). Main Outcome Measure(s): Treatment and eradication of the malignancy and achievement of a successful subsequent pregnancy and live birth. Result(s): The patient had no evidence of disease for 2 years after treatment. During that time she received preconception counseling by both a perinatologist and a reproductive endocrinologist. She conceived with the use of ultrasound monitoring to time intercourse specifically with ovulation from the contralateral ovary and had an uncomplicated pregnancy with a term delivery. Conclusion(s): By using several disciplines and subspecialists, this patient received personalized treatment for a rare cancer, focused at curing her cancer and optimizing her future fertility.

Original languageEnglish (US)
Pages (from-to)267.e5-267.e7
JournalFertility and sterility
Volume93
Issue number1
DOIs
StatePublished - Jan 1 2010

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Keywords

  • Fertility preservation
  • multidisciplinary care
  • pelvic malignancy
  • pregnancy after radiation therapy

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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