Lymphatic Drainage of Bartholin’s Gland in Fresh Adult Cadavers: Implications in Terms of Groin Surgery in Case of Bartholin’s Gland Carcinoma


Objective: To investigate the lymphatic drainage of Bartholin’s gland and its therapeutic implications in Bartholin’s gland carcinoma.
Materials and Methods: Data were obtained from the anatomical study of ten fresh female cadavers with groin and pelvic dissections after lymphatic channel and node staining by injection of Lipiodol dye solution into Bartholin’s gland.
Results: We distinguished three different lymphatic pathways: i) the superficial inguinal pathway, identified in 61.5% of cases, ii) the internal pudendal pathway (towards the pararectal fossa), identified in 30.8% of cases, and iii) the pelvic pathway, identified in 15.4% of cases, one after an inguinal pathway and the other following the labiocrural fold. No evidence of stained lymphatic structures was found in 31.6% of cases. The principal pathway was always ipsilateral.
Conclusion: Ipsilateral groin lymphadenectomy offers the most effective ratio between oncological safety and surgery-related complications.


Bartholin’s gland, carcinoma, lymphatic drainage, surgery, groin, inguinofemoral

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Article Type
Research Article
Publication history
Received: Mon 07, Feb 2022
Accepted: Tue 08, Mar 2022
Published: Mon 14, Mar 2022
© 2023 Lobna Ouldamer. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JSO.2022.01.01

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Lobna Ouldamer
Department of Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, Tours, France

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1.     Parker SL, Tong T, Bolden S, Wingo PA (1997) Cancer statistics, 1997. CA Cancer J Clin 47: 5-27. [Crossref]

2.     Chamlian DL, Taylor HB (1972) Primary carcinoma of Bartholin’s gland. A report of 24 patients. Obstet Gynecol 39: 489-494. [Crossref]

3.     Rosenberg P, Simonsen E, Risberg B (1989) Adenoid cystic carcinoma of Bartholin’s gland: a report of five new cases treated with surgery and radiotherapy. Gynecol Oncol 34: 145-147. [Crossref]

4.     Copeland LJ, Sneige N, Gershenson DM, McGuffee VB, Abdul Karim F et al. (1986) Bartholin gland carcinoma. Obstet Gynecol 67: 794-801. [Crossref]

5.     Dodson MG, Klegerman ME, Menon M, Kerman RH, Lange CF et al. (1978) Establishment and characterization of a squamous cell carcinoma of the vulva in tissue culture and immunologic evaluation of the host. Am J Obstet Gynecol 131: 606-619. [Crossref]

6.     Masterson JG, Goss AS (1955) Carcinoma of Bartholin gland; review of the literature and report of a new case in an elderly patient treated by radical operation. Am J Obstet Gynecol 69: 1323-1332. [Crossref]

7.     Nasu K, Kawano Y, Takai N, Kashima K, Miyakawa I (2005) Adenoid cystic carcinoma of Bartholin’s Gland. Case report with review of the literature. Gynecol Obstet Invest 59: 54-58. [Crossref]

8.     Way S (1960) Carcinoma of the vulva. Am J Obstet Gynecol 79: 692-697. [Crossref]

9.     Bassett A (1912) Revue de Chirurgie Orthopétique de l'Appareil Moteur 46: 546.

10.  Klob JM (1864) Carcinoma of Bartholin’s gland. Vienna: Pathologische. Anatomieder weiblichen sexualorgane.

11.  Huguier PC (1850) Mémoire sur les appareils sécréteurs des organes génitaux externes chez la femme et chez les animaux. Annales des sciences naturelles, 3ème série Zoologie, t.XIII, 271.

12.  Bruhns C (1998) Ueber die lymphgefässe der weiblichen genitalien nebst einigen bemerkungen über die topographie der leistendrüsen. Archiv Für Anat und Physiol Anat Abt 57-80.

13.  Cateula J (1931) Nouvelle note sur les lymphatiques du vagin. C. R. de la Société anatom. De Paris in Ann. D’anat. path. Et d’anat. norm. méd.-chir., 1930. t. VII, n°7, p903-904_ Nouvelle note in Ann. d’anat. path. Et an. n. 1931, n°8.

14.  Way S (1948) The anatomy of the lymphatic drainage of the vulva and its influence on the radical operation for carcinoma. Ann R Coll Surg Engl 3: 187-209. [Crossref]

15.  Parry Jones E (1963) Lymphatics of the vulva. J Obstet Gynaecol Br Commonw 70: 751-765. [Crossref]

16.  Reiffenstuhl G (1964) The lymphatics of the female genital organs. United States: J.B. Lippincott Company.

17.  Iversen T, Aas M (1983) Lymph draingae from the vulva. Gynecol Oncol 16: 179-189. [Crossref]

18.  Levenback C, Burke TW, Gershenson DM, Morris M, Malpica A et al. (1994) Intraoperative lymphatic mapping for vulva cancer. Obstet Gynecol 84:163-167. [Crossref]

19.  Levenback C, Coleman RL, Burke TW, Bodurka Bevers D, Wolf JK et al. (2001) Intraoperative lymphatic mapping and sentinel node identification with blue dye in patients with vulvar cancer. Gynecol Oncol 83: 276-281. [Crossref]

20.  Hampl M, Hantschmann P, Michels W, Hillemanns P, German Multicenter Study Group (2008) Validation of the accuracy of the sentinel lymph node procedure in patients with vulvar cancer: results of a multicenter study in Germany. Gynecol Oncol 111: 282-288. [Crossref]

21.  Hassanzade M, Attaran M, Treglia G, Yousefi Z, Sadeghi R (2013) Lymphatic mapping and sentinel node biopsy in squamous cell carcinoma of the vulva: Systematic review and meta-analysis of the literature. Gynecol Oncol 130: 237-245. [Crossref]

22.  Anatomica T (1998) International anatomical terminology. Federative Committee on Anatomical Terminology (FCAT). Stuttgart/New York: Thieme.

23.  Ercoli A, Delmas V, Fanfani F, Gadonneix P, Ceccaroni M et al. (2005) Terminologia Anatomica versus unofficial descriptions and nomenclature of the fasciae and ligaments of the female pelvis: a dissection-based comparative study. Am J Obstet Gynecol 193: 1565-1573. [Crossref]

24.  Ercoli A, Delmas V, Iannone V, Fagotti A, Fanfani F et al. (2010) The lymphatic drainage of the uterine cervix in adult fresh cadavers: Anatomy and surgical implications. Eur J Surg Oncol 36: 298-303. [Crossref]

25.  Budd GT, Groppe CW (1983) Adenoid cystic carcinoma of the salivary gland. Sustained complete response to chemotherapy. Cancer 51: 589-590. [Crossref]

26.  Balat O, Edwards CL, Delclos L (2001) Advanced primary carcinoma of the Bartholin gland: report of 18 patients. Eur J Gynaecol Oncol 22: 46-49. [Crossref]

27.  Cardosi RJ, Speights A, Fiorica JV, Grendys Jr E C, Hakam A et al. (2001) Bartholin’s gland carcinoma: a 15-year experience. Gynecol Oncol 82: 247-251. [Crossref]

28.  Leuchter RS, Hacker NF, Voet RL, Berek JS, Townsend DE et al. (1982) Primary carcinoma of the Bartholin gland: a report of 14 cases and review of the literature. Obstet Gynecol 60: 361-368. [Crossref]

29.  Woida FM, Ribeiro Silva A (2007) Adenoid cystic carcinoma of the Bartholin gland: an overview. Arch Pathol Lab Med 131: 796-798. [Crossref]

30.  Finan MA, Barre G (2003) Bartholin’s gland carcinoma, malignant melanoma and other rare tumours of the vulva. Best Pract Res Clin Obstet Gynaecol 17: 609-633. [Crossref]

31.  Wheelock JB, Goperlud DR, Dunn LJ, Oates JF III (1984) Primary carcinoma of the Bartholin’s gland: a report of ten cases. Obstet Gynecol 63: 820-824. [Crossref]

32.  DiSaia PJ, Creasman WT (1997) Invasive cancer of the vulva. P.J. DiSaia, W.T. Creasman (Eds.), Clinical gynecologic oncology, Mosby, St Louis, MO 228.

33.  Ouldamer L, Chraibi Z, Arbion F, Barillot I, Body G (2013) Bartholin’s gland carcinoma: Epidemiology and therapeutic management. Surg Oncol 22: 117-122. [Crossref]

34.  Sappey C (1874) Traité d'anatomie, physiologie et pathologie des vaisseaux lymphatiques, considérés chez l'homme et les vertébrés. Delahaye Paris 1874: 54-58.

35.  Liirmann K (1974) Das primle karzinom der Bartholinischen driise, Zentralbl. Gynaekol 96: 1044-1047.

36.  Visco AG, Del Priore G (1996) Postmenopausal Bartholin gland involvement: a hospital based cancer risk assessment. Obstet Gynecol 87: 286-290. [Crossref]

37.  Mazouni C, Morice P, Duvillard P, Bonnnier P, Castaigne D (2004) Contralateral groin recurrence in patiente with stage I Bartholin’s gland squamous celle carcinome and negative ipsilateral nodes: report on two cases and implications for lymphadenectomy. Gynecol Oncol 94: 843-845. [Crossref]

38.  Querleu D, Bonnier P, Morice P, Narducci F, Lhomme C et al. (2008) Initial management of gynecologic cancers: reference guides of the Société Française d'Oncologie Gynécologique (SFOG). Gynecol Obstet Fertil 36: 338-352. [Crossref]

39.  Eichner E (1957) In vivo studies on the pelvic lymphatics in women. Prog Gynecol 3.

40.  Slomovitz BM, Coleman RL, Oonk MHM, van der Zee A, Levenback C (2015) Update on Sentinel Lymph Node study for early-stage vulvar cancer. Gynecol Oncol 138: 472-477. [Crossref]

41.  Coleman RL, Ali S, Levenback CF, Gold MA, Fowler JM et al. (2013) Is bilateral lymphadenectomy for midline squamous carcinoma of the vulva always necessary? An analysis from Gynecologic Oncology Group (GOG) 173. Gynecol Oncol 128: 155-159. [Crossref]

42.  Barclay DL, Collins CR, Macey AB (1964) Cancer of the Bartholin’s gland: a review and report of 8 cases. Obstet Gynecol 24: 329-335. [Crossref]

43. Ohno T, Nakano T, Abe A, Sano T, Niibe Y et al. (2001) Mucinous adenocarcinoma of Bartholin gland treated with radiation therapy: a case report. Jpn J Clin Oncol 31: 226-230. [Crossref]