Abstract
Background : Mucinous adenocarcinoma of the Bartholin’s gland is extremely rare. Herein, we report a case of mucinous adenocarcinoma of the Bartholin’s gland suggested by brushing cytology of the vulva.
Case : An 82-year-old woman with a history of colon cancer and Paget’s disease of the breast presented with a cystic mass on the left side of the vulva. Brushing cytology revealed tumor cells forming small clusters or isolated tumor cells in a mucinous background. Many of the cells had crescent-shaped nuclei and intracytoplasmic mucin, so-called signet-ring cells. Based on these findings, mucinous adenocarcinoma was suspected. Histologically, the tumor cells had abundant cytoplasm and eccentric nuclei, and were found floating loosely or in a fence-like arrangement in a mucus lake. The tumor tissue revealed transition from the normal Bartholin’s gland tissue. Immunohistochemically, the tumor cells were positive for CK20, CK7, CDX2, ER and CA125, and negative for GCDFP-15. Histopathologically and immunohistochemically, this tumor was distinguishable from colon cancer metastasis, Paget’s disease of the breast, and mucinous adenocarcinoma arising in ectopic breast tissue.
Conclusion : Mucinous adenocarcinoma of the Bartholin’s gland can scarcely be diagnosed definitively on the basis of cytology alone. Clinical information, including imaging study findings, as well as the vulvar cytologic, histopathological and immunohistochemical findings should be concurrently considered for accurate diagnosis of mucinous adenocarcinoma of the Bartholin’s gland.
