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Re: Bartholin's From: D. Ashley Hill, MD (dahmd@cfl.rr.com) Fri Sep 26 23:07:52 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Joanne Bulley, MD: "Re: Bartholin's" Previous message: guy.venezia@ssfhs.org: "prednisone in pregnancy" In reply to: Efrain Ramirez: "Re: Bartholin's" Next in thread: Joanne Bulley, MD: "Re: Bartholin's" Reply: Joanne Bulley, MD: "Re: Bartholin's" Why not marsupialize using the "window" procedure reported by Cho et al? That way you excise a segment of the cyst which you can send for biopsy. Although some texts advocate excision of Bartholin gland lesions in women over 40 to "rule out adenocarcinoma" a retrospective report from 1996, referenced below, found that the incidence of Bartholin gland adenocarcinoma in post-menopausal women was 0.114 per 100,000 woman-years. That's an extremely low incidence, which probably does not justify excision. Visco AG, Del Priore G. Postmenopausal bartholin gland enlargement: a hospital-based cancer risk assessment. Obstet Gynecol 1996;87:286-90. Ashley At Tue, 23 Sep 2003, Efrain Ramirez wrote: > >The site was "in a broken state" as Bruce stated --- > >Excision.. why not? > >>At Mon, 22 Sep 2003, Joanne Bulley, MD wrote: >> >>I was surprised that I got no responses on this one - is it really a >>"no-brainer" - if it looks like a duck ... maybe I should just treat >>with soaks an observation like Bartholin's in the 20-something woman. >> >>--- Joanne >> >>I know we've discussed this before ... >>What would you do: >> >>Mid 40's woman has a Bartholin's duct cyst which develops into an abcess >>and spontaneously drains. >> >>1. hot soaks for 24-48 hours and just observe (how soon - 1 month, 6 >>months or something else) >> >>2. go to OR and marsupialize and biopsy the duct wall (because of >>others recommending biopsy of any Bartholin's if the woman is over 40) >>(I have seen two patients with Adenocarcinoma of the Bartholin's gland - >>duct) >> >>3. Something else (and describe) >> >>If you biopsy - WHAT do you biopsy - the lower end of the duct where you >>are marsupializing - or further up??? >> >>Thanks - I look forward to the discussion! >> >>Joanne >> >>-- >>Joanne Bulley, MD >>Keene, NH, USA >> >>----- >>Work to create peace everywhere you go and with everything you do. >>----- >>Let us accept truth, even when it surprises us and alters our views. >>-George Sand >> >-- >"The opposite of a correct statement is a false statement. >But the opposite of a profound truth may well be another profound truth." > >Niels Bohr (1885 - 1962) > -- D. Ashley Hill, MD Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Orlando, Florida Next message: Joanne Bulley, MD: "Re: Bartholin's" Previous message: guy.venezia@ssfhs.org: "prednisone in pregnancy" In reply to: Efrain Ramirez: "Re: Bartholin's" Next in thread: Joanne Bulley, MD: "Re: Bartholin's" Reply: Joanne Bulley, MD: "Re: Bartholin's"

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