SPECTACULAR RESPONSE OF A LOCALLY ADVANCED VULVAR CARCINOMA IN A RELATIVELY YOUNG PATIENT: SUCCESSFUL MULTIMODAL STRATEGY USING INDUCTION CHEMOTHERAPY AND CONCURRENT CHEMORADIOTHERAPY

Introduction:Vulvar carcinoma is a rare malignancy, and locally advanced inoperable T4 tumors represent a major therapeutic challenge, particularly in relatively young patients. HPV-associated tumors, often p16-positive, are characterized by rapid and aggressive local invasion.

Case Presentation: We report the case of a 51-year-old woman with HPV 16 and p16-positive T4N1 inoperable vulvar carcinoma. She received weekly induction chemotherapy consisting of paclitaxel and carboplatin for 12 cycles, followed by concurrent chemoradiotherapy using IMRT and cisplatin. The patient experienced a spectacular tumor regression, both clinically and radiologically, with complete disappearance of inguinal lymphadenopathy and near-complete regression of vaginal and perineal extensions. Treatment tolerance was excellent.

Discussion: This case highlights the effectiveness of a multimodal strategy in a relatively young patient with inoperable T4 vulvar carcinoma. Induction chemotherapy allows significant tumor downstaging prior to chemoradiotherapy, while maintaining an appropriate interval enhances tolerance and recovery.A multidisciplinary and individualized approach is essential to maximize response, optimize the chance of cure, and preserve quality of life.

Conclusion: The combination of induction chemotherapy followed by concurrent chemoradiotherapy represents a safe and effective therapeutic option for patients with locally advanced,inoperable vulvarcarcinoma, including relatively young women.