Neoadjuvant chemotherapy followed by radical vulvectomy for adenoid cystic carcinoma of Bartholin’s gland: a case report

BACKGROUND: Adenoid cystic carcinoma (ACC) of the Bartholin’s gland is a rare cancer of the female genital tract for which there is no consensus on treatment. As there are no current reports on neoadjuvant chemotherapy followed by surgery for this disease, our case explores the effectiveness of neoadjuvant chemotherapy. CASE DESCRIPTION: We report a case of ACC of Bartholin’s gland. The patient is a 69-year-old woman with a left vulvar mass. Pelvic magnetic resonance imaging (MRI) showed a left perineal occupying lesion with indistinct boundaries to the surrounding tissues. The patient received two cycles of neoadjuvant chemotherapy with a regimen of paclitaxel combined with cisplatin and the mass was significantly reduced. Subsequently, she received a radical vulvectomy and left inguinal lymph node dissection. The operation was successful, and the patient was treated with simultaneous radiotherapy and chemotherapy after the surgery. The patient is currently 14 months postoperative and reports no significant pain with normal urination and defecation. The pelvic MRI was reviewed regularly, and there was no sign of recurrence. CONCLUSIONS: After neoadjuvant chemotherapy, the extent of the lesion was significantly reduced, which reduced the difficulty of surgery, thus reducing surgical complications and enabling complete resection of the tumor tissue. Based on the treatment of this patient, we speculate that preoperative neoadjuvant chemotherapy may be a better choice for patients with extensive and fixed lesions.