Fluorescein mapping for identification of residual satellite vulvar Paget's lesion

Allison Joyce Siegel, Malgorzata Budzynska, Brandon Oleg Litvak, Ofri Peled, Letizia Schreiber, Sofia Leytes, Tally Levy*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Vulvar Paget disease (VPD) is a rare neoplastic condition exhibiting extensive multifocal involvement. It is clinically difficult to distinguish the margins of VPD from normal skin resulting in involved surgical margins leading to frequent lesion persistence and repeated excisions. Recently, fluorescein mapping has shown promise in providing accurate surgical margins in VPD. However, utilization of this technique after previous resection has not been explored. Case: A 63-year-old female underwent wide local excision of a large microinvasive VPD with involved resection margins. Two months later, the patient underwent additional surgery to excise the involved margins and for sentinel inguinal lymph nodes evaluation. With gross visualization, the vulvar skin appeared normal. However, after intravenous fluorescein sodium injection and Wood's lamp illumination, residual satellite pathological area was observed and resected, revealing more microinvasive tumor. Conclusion: Fluorescein mapping directly highlights sites of involvement in VPD and provides an improved estimation of disease extent which is otherwise not clinically visible.

Original languageEnglish
Article number101284
JournalGynecologic Oncology Reports
Volume50
DOIs
StatePublished - Dec 2023

Keywords

  • Fluorescein Mapping
  • Vulvar Paget's disease

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