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 Citations (Scopus)

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)
JournalFertility and Sterility
Volume93
Issue number1
DOIs
StatePublished - Jan 1 2010

Fingerprint

Fertility
Neoplasms
Pregnancy
Therapeutics
Fertility Preservation
losigame
Synovial Sarcoma
Vulva
Brachytherapy
Live Birth
Ovulation
Lymph Node Excision
Needles
Counseling
Ovary
Radiotherapy
Outcome Assessment (Health Care)
Survival

Keywords

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

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

A multidisciplinary approach to fertility-sparing therapy for a rare vulvar tumor. / Dicken, Cary L.; Lieman, Harry J.; Dayal, Ashlesha K.; Mutyala, Subhakar; Einstein, Mark H.

In: Fertility and Sterility, Vol. 93, No. 1, 01.01.2010.

Research output: Contribution to journalArticle

Dicken, Cary L. ; Lieman, Harry J. ; Dayal, Ashlesha K. ; Mutyala, Subhakar ; Einstein, Mark H. / A multidisciplinary approach to fertility-sparing therapy for a rare vulvar tumor. In: Fertility and Sterility. 2010 ; Vol. 93, No. 1.
@article{98de254249fe438fafcfe37a24a17f96,
title = "A multidisciplinary approach to fertility-sparing therapy for a rare vulvar tumor",
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.",
keywords = "Fertility preservation, multidisciplinary care, pelvic malignancy, pregnancy after radiation therapy",
author = "Dicken, {Cary L.} and Lieman, {Harry J.} and Dayal, {Ashlesha K.} and Subhakar Mutyala and Einstein, {Mark H.}",
year = "2010",
month = "1",
day = "1",
doi = "10.1016/j.fertnstert.2009.07.1007",
language = "English (US)",
volume = "93",
journal = "Fertility and Sterility",
issn = "0015-0282",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - A multidisciplinary approach to fertility-sparing therapy for a rare vulvar tumor

AU - Dicken, Cary L.

AU - Lieman, Harry J.

AU - Dayal, Ashlesha K.

AU - Mutyala, Subhakar

AU - Einstein, Mark H.

PY - 2010/1/1

Y1 - 2010/1/1

N2 - 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.

AB - 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.

KW - Fertility preservation

KW - multidisciplinary care

KW - pelvic malignancy

KW - pregnancy after radiation therapy

UR - http://www.scopus.com/inward/record.url?scp=72749085026&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=72749085026&partnerID=8YFLogxK

U2 - 10.1016/j.fertnstert.2009.07.1007

DO - 10.1016/j.fertnstert.2009.07.1007

M3 - Article

VL - 93

JO - Fertility and Sterility

JF - Fertility and Sterility

SN - 0015-0282

IS - 1

ER -