Carcinoma of Bartholin's gland

C ARCINOMA of Bartholin’s gIand is very rare and probabIy has often been a missed diagnosis. The earIiest reference to a maIignancy of this gIand was made by KIob in 1864. In his book on the pathoIogica1 anatomy of the female sex organs he mentioned, in connection with chronic inff ammation of BarthoIin’s gIand, a tumor formation which he described as resembIing a cystosarcoma of the breast. He thought that this maJignancy resuIted from the chronic inffammation. In this same book, cysts of BarthoJin’s gIand and carcinoma of the vuIva are discussed separateIy with reference to the earlier Iiterature but a definite, indisputabIe carcinoma of Bartholin’s gIand is not described. Since that time occasional reports of one to three cases have appeared. SeveraI authors, especiaIIy the German and EngIish, have aIso reviewed the literature, coIIected the known cases, summarized the data and incidentaIIy have provided extensive bibIiographies. The most compIete and most vaIuabIe of these studies have been made by Honan (1897), Sitzenfrey (1906), Spencer (1914), Wittkopf (ISIS), FaJJs (I&, Ham (1933)~ Rabson and Meeker (1938), GobeI (1938) and Simendinger ( 1939). The exact incidence of this tumor is diffIcuIt to determine. Many of the reported cases, especiaIIy the earIier ones, are incompIete and the detaiIs essentia1 for verification of their diagnosis are Jacking. It is aIso obvious that many of these cases are reported as carcinomas of the vuIva rather than of BarthoIin’s gIand because they are seen too Iate and when the growth is too extensive to permit determination of their exact origins. Another factor which contributes to the uncertainty as to the actua1 incidence of this tumor is the possibIe tota Jack of diagnosis in earIy cases removed without subsequent Jaboratory study. This possibiIity is suggested by the fact that, in many reported cases, the true nature of the Iesion was discovered onIy at operation or when the materia1 was examined by a pathoIogist. UnIess a11 cysts and abscesses of BarthoIin’s gIands are made the subject of carefu1 pathoIogic study, the incidence of its carcinoma in its earIy stages wiI1 be uncertain. Rabson and Meeker, in 1938, reported a coIIection of fifty-six cases from the worId Iiterature and added two of their own. In the same year, GijbeI coIIected fifty cases and added three. In May, of 1939, Simendinger added eighteen cases to a Iist of twenty made in 1923 by FaIIs. These two authors attempted to list onIy the bona fide cases and to give comparative data as regards age of patient, type of tumor found, metastases, treatment and resuIts. Simendinger had four cases, incIuding his own, which Rabson and Meeker had not reported. In November, of 1940, Cosbie reported one additional case which was incIuded in his study of fifty-nine cases of vuIvar carcinoma. In this same month, Taussig pubIished a report of his experience with 155 cases of vuIvar carcinoma, nine of which originated in BarthoIin’s gIand. It is evident that aIthough there are about seventy-five cases reported in the Iiterature, a great number of these are pubIished with inadequate data and may not be accepted as proved cases of BarthoIin gIand carcinoma. This infrequent occurrence of BarthoIin gIand carcinoma is aIso reffected in textbooks and treatises on gynecoIogy where it is usuaIIy mentioned in connection with the discussion of carcinoma of the vuIva. It is given the same course and the same