Vulvar sweat gland adenocarcinoma

　　Etiology:Vulvar sweat gland adenocarcinoma mostly originates from apocrine glands, but can also come from eccrine glands. Its histological morphology is very similar to normal sweat glands. The tumor mass invades the epidermis and has a morphological transition with the adjacent apocrine glands, and can also infiltrate into the deep layer, sometimes invading the nerve sheath. The cytoplasm of the cancer cells is rich and eosinophilic, and can produce mucus. The degree of differentiation of cancer cells is 93% at grade I.

　　Vulvar sweat gland adenocarcinoma mostly originates from apocrine glands, but can also come from eccrine glands. Its histological morphology is very similar to normal sweat glands. The tumor mass invades the epidermis and has a morphological transition with the adjacent apocrine glands, and can also infiltrate into the deep layer, sometimes invading the nerve sheath. The cytoplasm of the cancer cells is rich and eosinophilic, and can produce mucus. The degree of differentiation of cancer cells is 93% at grade I. Due to surface wear, ulceration can occur, and in addition to the weakened resistance and immunity of cancer patients, hemorrhage and infection may occur.

　　Symptoms

　　1. Course of disease: The development is usually slow, but a small number of patients have an acute onset, and 30% of patients have a course of less than 1 year. There are also long-term manifestations of slowly growing subcutaneous nodules, and sometimes trauma can promote the rapid growth of the tumor.

　　2. Local itching of the vulva:It is a common symptom of vulvar sweat gland cancer and can also be asymptomatic.

　　3. Vulvar mass: The diameter is usually

　　Symptoms

　　Sweat gland cancer is usually a solitary subcutaneous nodule or mass, with firm texture; it often adheres to the skin, and the skin on the surface of the mass is normal or slightly pink, sometimes with dilated capillaries and occasionally serous or bloody effusion; if the mass is large, it often ulcerates to form cauliflower-like masses and is accompanied by secondary infection. Physical examination often shows that the tumor is located on the labia majora, with intact skin on the surface, and superficial ulcers or eczema-like changes may also occur. Sweat gland cancer has a low malignancy and progresses slowly, and in the late stage, the lesion can infiltrate the muscle layer, or involve the vagina and lead to inguinal lymph node metastasis and lung metastasis.

　　Vulvar adenocarcinoma is very rare, accounting for only 0.5% of vulvar malignant tumors. The age of onset is 30-67 years, and women are more common than men.

　　First, Prognosis after treatment

　　Early cases of vulvar adenocarcinoma can be cured after surgical resection. Late-stage cases with lymph node or lung metastasis have a poor prognosis.

　　Second, Prevention

　　1, Regular physical examination: to achieve early detection, early diagnosis, and early treatment.

　　2, Do a good follow-up: prevent the deterioration of the disease.

　　3, Pay attention to personal hygiene, especially the hygiene of the genital area during menstruation and postpartum period.

　　4, Enhance physical fitness and improve immunity: Pay attention to the combination of work and rest, participate in more physical exercise, and eat more fresh fruits and vegetables rich in vitamins.

　　The following are the examination methods for vulvar adenocarcinoma:

     2, X-ray films, ultrasound, radionuclide scanning, or CT imaging; histopathological examination.

　　1, Routine blood tests, secretion tests, and tumor marker tests.

　　First, Dietetic Recipe for Vulvar Adenocarcinoma

　　1, Astragalus and Poria cocos Porridge

　　Ingredients: Raw Astragalus 30 grams, Poria cocos 50 grams, glutinous rice 200 grams.

　　Preparation: First, decoct raw Astragalus and Poria cocos into a decoction, then add it to the washed glutinous rice and cook into porridge. It has the effects of invigorating the body, promoting diuresis, and detoxifying, suitable for patients with external genital malignant tumors that do not heal.

　　2, Millet and Lotus Seed Soup(Manual of Diet and Cancer Prevention)

　　Ingredients: Millet 50 grams, lotus seeds 20 grams, red dates.

　　Preparation: First, cook lotus seeds until soft, add red dates and millet powder, and simmer for 15 minutes. Take 2 doses, morning and evening, which have the effects of invigorating the body and nourishing the blood, strengthening the spleen and dampness, and enhancing the body's ability to fight cancer.

　　3, Portobello Mushroom Rolls

　　Cut portobello mushrooms into strips, stir-fry them with vegetable oil until cooked, then remove and sprinkle with a little salt; beat the eggs, fry them into a thin omelette, stuff the cooked portobello mushroom strips inside, roll them up, and serve. Suitable for cancer patients after surgery and those with poor taste after radiotherapy and chemotherapy.

　　4, Others

　　Bitter melon 1 piece, beef 50 grams, garlic 5 grams, scallion 2 grams, chili 10 grams, sugar, soy sauce, vinegar, and cornstarch as needed. Wash the bitter melon, cut it in half, remove the seeds, and slice it thinly. Heat the pan, add the bitter melon, and stir-fry for 2 minutes, then serve on a plate. Wash the garlic, scallion, and chili, chop them, heat oil in the pan, stir-fry until fragrant, then add the stir-fried bitter melon, add a little salt, sugar, soy sauce, and vinegar, and stir-fry over high heat for 1-2 minutes, then remove from heat. Wash the beef, slice it into thin strips, soak it in cornstarch and soy sauce for 5 minutes, then quickly stir-fry in a hot pan with oil until cooked, add to the bitter melon, and stir a few times. It can strengthen the spleen and stomach, clear heat and detoxify, and boost the body's ability to fight cancer. Suitable for cancer patients with weak spleen and stomach and irritability.

　　5, Nourishing Double Ear Soup

　　Black fungus and white fungus each 200 grams. Black fungus and white fungus are soaked in water, stir-fried, then added with fresh soup and seasonings, cooked until thick and flavorful, and finally thickened with starch. It can be used as a nutritious delicacy after surgery and radiotherapy.

　　6, Millet Congee

　　Firstly, wash and dry Job's tears, grind them into fine powder, take 30-60 grams of the product each time, cook congee with 100 grams of glutinous rice, and it can be served for breakfast and dinner. Scientific experiments have found that coixenol has the effect of preventing the growth and killing of cancer cells.

　　7. Scallion and meat dumplings

　　Scallion contains a trace of selenium, which has the effect of inhibiting carcinogens in the body and can limit the development of tumors, making them shrink or even disappear. Make dumplings with scallion and meat in a 4:1 ratio, add appropriate seasonings, steam and eat. It is suitable for all malignant tumors and can prevent the recurrence and metastasis of tumors.

　　Secondly, foods that are good for the body for vulvar sweat gland adenocarcinoma:

　　1. Eat more foods that have anti-vulvar tumor and leukoplakia effects, such as sesame, almond, wheat, barley, loofah, black chicken, cuttlefish, snake, pork pancreas, chrysanthemum, prune, peach, lychee, portulaca, chicken blood, eel, abalone, crab, scallop, sardine, clam, tortoise shell.

　　2. For pain, eat scallops, red, lobsters, clam, sea cucumber, tiger fish, beetroot, mung bean, radish, chicken blood.

　　3. For itching, eat amaranth, Chinese cabbage, rapeseed, taro, kelp, laver, chicken blood, snake meat, pangolin.

　　4. To enhance physical fitness and prevent metastasis, eat silver ear, black fungus, mushrooms, hedgehog mushrooms, chicken gizzards, sea cucumber, Job's tears, walnuts, crabs, Agama, needlefish, etc.

　　5. After vulvar sweat gland adenocarcinoma surgery, it consumes Qi and injures blood, so it is advisable to eat more Qi-nourishing and blood-nourishing foods, such as jujube, longan, adzuki bean, glutinous rice, lychee, mushrooms, carrots, quail eggs, lotus root powder, beans, etc.

　　6. Radiotherapy after vulvar sweat gland adenocarcinoma surgery: It consumes Yin and fluid, so it is advisable to eat more nourishing Yin and fluid products, such as spinach, Chinese cabbage, lotus root, radish, watermelon, banana, grape, sea cucumber, sugarcane, lily, etc.

　　7. Chemotherapy after vulvar sweat gland adenocarcinoma surgery: It can damage both Qi and blood, so it is advisable to often eat foods that nourish Qi and blood, such as mushrooms, walnuts, lotus seeds, mulberry, congee, jujube, longan, sea cucumber, etc.

　　Thirdly, foods that should not be eaten for vulvar sweat gland adenocarcinoma:

　　1. Avoid stimulants such as coffee.

　　2. Avoid spicy and刺激性 foods such as scallion, garlic, ginger, and cassia.

　　3. Avoid greasy, fried, moldy, and salted foods.

　　4. Avoid stimulants such as rooster and pork head meat.

　　5. Avoid seafood.

　　6. Avoid warm foods such as mutton, dog meat, chive, pepper, etc.

　　7. Avoid smoking and drinking.

　　Firstly, the traditional Chinese medicine treatment method for vulvar sweat gland adenocarcinoma: treatment with Chinese herbs:

　　1. The main symptoms of blood heat and damp toxin type:

　　Skin redness-like skin lesions or erosion with redness, accompanied by exudate and hemorrhage, foul smell, bleeding upon contact, difficult to stop bleeding, bitter mouth and dry throat, irritability, heartache, yellow and red urine, constipation, red tongue with greasy yellow fur, and slippery and rapid pulse.

　　Therapeutic method: Clear heat, cool blood, and remove dampness and detoxify.

　　Prescription: Yinhuang Decoction (from 'Yangyi Xinshen Ji') combined with Baimai Shen Shi Decoction (from 'Yangke Xinshen Ji') with modifications.

　　2. The main symptoms of liver depression and blood dryness type:

　　Skin papules or small nodules, gradually enlarged, hard in texture, with elevated edges, and ulcers in the middle. The ulcers do not heal after ulceration, accompanied by poor emotional state, irritability, poor sleep, chest and hypochondriac pain, dry and chapped lips, dry and tough stools, red tongue with thin yellow or thin white fur, and wiry and thin pulse.

　　Therapeutic method: Soothe the liver and regulate Qi, nourish blood and moisten dryness.

　　3. Main Symptoms of Phlegm Toxin Congestion Type:

　　Skin papules or nodules, central ulceration or elevated edges, dark red color, hard and uneven, local stabbing pain, accompanied by rough skin, dark complexion, dark purple lips, dark red tongue with spots, and fine,涩脉.

　　Treatment Method: Activate Blood and Calm Wind, Clear Heat and Detoxify.

　　4. Main Symptoms of Qi and Blood Deficiency Type:

　　Long-standing illness, fatigue, yellowish complexion, emaciated, poor appetite, lumbago, dizziness, blurred vision, shortness of breath, and reluctance to speak, skin masses become ulcerous, and it is difficult to remove the malignant flesh. A slight touch can cause bloody discharge, pale and white tongue with tooth marks, thin white fur, and fine, weak pulse.

　　Treatment Method: Tonify Qi and Blood, Reinforce the Body and Expel Pathogenic Factors.

　　Secondly, Western Medical Treatment Methods for Vulvar Adenocarcinoma

　　1. Surgical Treatment

　　Surgery is the main treatment method for adenocarcinoma of the sweat glands. For early lesions, extensive resection at the lesion site can be performed, and complete resection of the tumor can lead to cure. For advanced lesions, extensive vulvar resection should be performed, and for those with enlarged inguinal lymph nodes, inguinal lymph node dissection is required. The extent of resection varies according to the size of the tumor. For small lesions with clear boundaries, a margin of 3 cm from the tumor edge is sufficient. For large tumors, especially those with unclear boundaries, the skin should be incised 5 cm from the tumor edge, and the skin flap should be dissected subcutaneously 2-3 cm after the skin incision before extensive resection. The extent of base resection needs to be determined according to the depth of tumor infiltration. When it involves adjacent organs, it is often necessary to resect the involved organs as well.

　　Since adenocarcinoma of the sweat glands mainly presents as locally invasive growth, after infiltrating deeply, it fixes the base and is not easy to move, and it is often mistakenly believed to be inoperable. For this, patients should not be lightly deprived of their treatment opportunities. For adenocarcinoma of the sweat glands located in the inguinal region, when it involves the femoral vessels and nerves, a hemipelvic resection can still offer hope for cure.

　　2. Chemotherapy

　　Adenocarcinoma of the sweat glands is generally not sensitive to chemotherapy drugs, but the addition of anticancer chemotherapy to surgery for advanced vulvar adenocarcinoma may improve the prognosis, and combined chemotherapy can sometimes temporarily alleviate symptoms. Commonly used drugs include cyclophosphamide (CTX), 5-fluorouracil (5-Fu), vincristine (VCR), bleomycin (BLM), methotrexate (MTX), actinomycin D (ACTD), and others.

　　3. Radiotherapy

　　Adenocarcinoma of the sweat glands is not sensitive to radiotherapy, but for those with late-stage lesions that cannot be surgically removed, palliative radiotherapy can be tried, and sometimes it can achieve good therapeutic effects.