Epithelial-myoepithelial carcinoma with high-grade transformation of bartholin gland - A case report and literature review.

[OBJECTIVE] This case report and literature review aims to highlight the diagnostic challenges and treatment of epithelial-myoepithelial carcinoma (EMC) with high-grade transformation (HGT) of the Bartholin gland, a rare and aggressive tumor.

[CASE REPORT] A 51-year-old perimenopausal Indonesian woman with a 20-year history of untreated left Bartholin cyst infection presented with a painful vulvar mass and vulvar bleeding. Imaging revealed a 5 cm lobulated mass in the left vulva, and a biopsy confirmed poorly differentiated carcinoma. Immunohistochemistry demonstrated features consistent with epithelial-myoepithelial carcinoma. After a radical vulvectomy and lymph node dissection, pathology revealed a biphasic tumor with areas of high-grade transformation.

[CONCLUSION] EMC with HGT of the Bartholin gland is exceedingly rare and requires careful immunohistochemical analysis for accurate diagnosis. A multidisciplinary approach combining surgery and adjuvant therapy is critical to optimize outcomes, particularly in cases with aggressive features or incomplete resections. Furthermore studies are necessary to establish standardized treatment guidelines for such rare malignancies.