Iranian Society of Gynecology Oncology


1 Department Gynecology Oncology, Tehran University of Medical Sciences, Tehran, Iran

2 Department Thorax surgery, Tehran University of Medical Sciences, Tehran, Iran

3 Department Gynecology Oncology, Iran University of Medical Sciences, Tehran, Iran


Introduction: The incidence of vulvar cancer is nearly 5% of all gynecologic malignancies and almost 95% of vulvar cancers are squamous cell carcinoma (SCC). Recurrence is possible in 4 ways: local, regional, pelvic, and distant. In a cohort of 391 patients with vulvar SCC, distant metastasis was reported 5% .The common sites of distant metastasis are pelvic nodes, lung, and liver. Both skin and bone metastasis are rare in vulvar SCC.
Case Presentation: The current report presented a 58-year-old female with the diagnosis of vulvar SCC. She was the 11th cutaneous metastasis, 13th bone metastasis, and the 1st case with simultaneous bone and skin metastasis reported in the last 60 years.
Conclusions: It is necessary to consider any lesion on the vulve, especially in menopause females, and it should be the low threshold for biopsy to avoid delay in detection. After completion of selective treatment, the exact follow-up should be considered to discover metastases.


  1. Trimble CL, Hildesheim A, Brinton LA, Shah KV, Kurman RJ. Heterogeneous etiology of squamous carcinoma of the vulva. Obstet Gynecol. 1996;87(1):59-64. [DOI:10.1016/0029-7844(95)00351-7]
  2. Paladini D, Cross P, Lopes A, Monaghan JM. Prognostic significance of lymph node variables in squamous cell carcinoma of the vulva. Cancer. 1994;74(9):2491-6.<2491::AID-CNCR2820740916>3.0.CO;2-5 [DOI:10.1002/1097-0142(19941101)74:93.0.CO;2-5]
  3. Homesley HD, Bundy BN, Sedlis A, Yordan E, Berek JS, Jahshan A, et al. Assessment of current International Federation of Gynecology and Obstetrics staging of vulvar carcinoma relative to prognostic factors for survival (a Gynecologic Oncology Group study). Am J Obstet Gynecol. 1991;164(4):997-1003. [DOI:10.1016/0002-9378(91)90573-A]
  4. Prieske K, Haeringer N, Grimm D, Trillsch F, Eulenburg C, Burandt E, et al. Patterns of distant metastases in vulvar cancer. Gynecol Oncol. 2016;142(3):427-34. [DOI:10.1016/j.ygyno.2016.07.009] [PMID]
  5. Seward SM, Richardson DL, Leon ME, Zhao W, Cohn DE, Hitchcock CL. Metastatic squamous cell carcinoma of the vulva to the lung confirmed with allelotyping. Int J Gynecol Pathol. 2009;28(5):497-501. [DOI:10.1097/PGP.0b013e3181a23c6c] [PMID]
  6. Agrawal A, Wood KA, Giede CK, Chibbar R. A case of kidney metastasis in vulvar squamous cell carcinoma: A case report and review of literature. Case Rep Clin Med. 2013;02(05):306-9. [DOI:10.4236/crcm.2013.25082]
  7. Jafri SIM, Ali N, Farhat S, Malik F, Shahin M. The tell-tale heart: A case of recurrent vulvar carcinoma with cardiac metastasis and review of literature. Gynecol Oncol Rep. 2017;21:20-3. [DOI:10.1016/j.gore.2017.06.004] [PMID]
  8. Wang AR, O'Brien M, Ross R, Long T, Robinson-Bostom L. Epidermotropic metastasis from vulvar squamous cell carcinoma: a rare cutaneous manifestation. J Am Acad Dermatol. 2010;63(6):1088-91. [DOI:10.1016/j.jaad.2009.07.036]
  9. Tjalma WA, Watty K. Skin metastases from vulvar cancer: a fatal event. Gynecol Oncol. 2003;89(1):185-8. [DOI:10.1016/S0090-8258(03)00063-5]
  10. Ghaemmaghami F, Modares M, Behtash N, Moosavi AZ. Multiple, disseminated cutaneous metastases of vulvar squamous cell carcinoma. Int J Gynecol Cancer. 2004;14(2):384-7. [DOI:10.1111/j.1048-891x.2004.014227.x] [PMID]
  11. Cianfrani T, Smith JJ. Inflammatory diffuse cutaneous metastatic carcinoma from epidermal carcinoma of the vulva; report of a case. Obstet Gynecol. 1956;8(4):500-3.
  12. Santala M, Syrjanen K, Saarikoski S. Squamous cell carcinoma of the vulva with cutaneous metastases. Acta Obstet Gynecol Scand. 1989;68(3):271-3. [DOI:10.3109/00016348909021002] [PMID]
  13. Tobias DH, Smith HO, Jones JG, Anderson P, Runowicz CD, Goldberg GL. Cutaneous metastases from squamous cell carcinoma of the vulva. A case report and review of the literature. Eur J Gynaecol Oncol. 1995;16(5):382-6.
  14. Kulkarni R, Bradford WP. Squamous cell carcinoma of the vulva metastasizing to the skin. Acta Obstet Gynecol Scand. 1995;74(7):571-2. [DOI:10.3109/00016349509024393] [PMID]
  15. Dudley C, Kircik LH, Bullen R, Snow S, Landeck A, Buchler D. Vulvar squamous cell carcinoma metastatic to the skin. Dermatol Surg. 1998;24(8):889-92. [DOI:10.1016/S1076-0512(97)00185-4] [PMID]
  16. Ceydeli A, Rucinski J, Klipfel A. Vulvar squamous cell carcinoma metastatic to skin of the forearm. Dermatol Surg. 2003;29(6):662-3. [DOI:10.1097/00042728-200306000-00024] [PMID]
  17. Bahner JD, Scott JF, Shoureshi P, Honda K, Gerstenblith MR. Metastastic vulvar squamous cell carcinoma mimicking genital herpes. JAAD Case Rep. 2016;2(5):387-9. [DOI:10.1016/j.jdcr.2016.08.004] [PMID]