Adenoid cystic carcinoma of the Bartholin's gland: a rare tumor unmarked by persistent vulvar pain in a postmenopausal woman.

INTRODUCTION: Adenoid cystic carcinoma (ACC) of the Bartholin's gland is a rare malignancy characterized by slow growth, local invasion and perineural infiltration. CASE: A 64-year-old postmenopausal woman presented with persistent vulvar pain. Local examination revealed a 2 x 2 cm painful vulvar nodule. Nodule was excised and ACC originating in the Bartholin's gland with positive resection margin was determined in pathological examination. We performed hemivulvectomy and ipsilateral inguinal lymph node dissection. Pathology showed that the resection margins were free of tumor and there was no lymph node metastasis. DISCUSSION: In cases of persistent vulvar pain without swelling, complete vulvovaginal evaluation should be done to prevent delay in diagnosis of Bartholin's gland cancer. Treatment modality must be tailored to each patient, though there is no consensus on the treatment.