Preservation of the vulva in stage III squamous cell carcinoma with intra-arterial chemotherapy

Abstract

A patient with stage III vulvar squamous cell carcinoma who was successfully treated with intra-arterial and intravenous chemotherapy and subsequent local excision is presented. The tumor was located on the left side of the vulva. Chemotherapy initially was administered into the left internal iliac artery. After two courses of the intra-arterial infusions, the tumor was no longer visible macroscopically. Two additional courses of chemotherapy were given intravenously to treat possible metastases to the lymph nodes. After the chemotherapy, the tumor site in the vulva was excised. A few small nests of tumor cells were identified in the excised specimen. The appearance of the vulva after surgery was quite natural and similar to that of a woman without disease. The patient is alive and disease-free 36 months after surgery. Conservative therapy, which includes intra-arterial and intravenous chemotherapy, should be considered for selected women with advanced vulvar squamous cell carcinoma.