How would you treat a small cell carcinoma with a 4 cm right Bartholin's gland primary and a single small right inguinal adenopathy?

It’s like limited-stage SCLC would be treated with cis plus etoposide and RT (60-66 Gy). Will favor no elective pelvic node RT if pure small cell carcinoma and no mixed component.

Although data is limited to guide this particular patient situation, I would agree that the first step should be systemic therapy - at least 4 cycles of cis/etop. Subsequently, concurrent chemoradiation or surgical resection should be considered. We often borrow data from SCLC and apply it to extrapulmonary small cell cancer, but we recently analyzed available data (Fan et al., PMID 41308227) and found that for smaller tumors, especially in the cervix, surgery may render longer OS.