Skin metastases from vulvar cancer: a fatal event

Cutaneous metastases from a vulval cancer are exceptional with only 4 reported cases in the literature.

The present case is a patient who had a radical vulvectomy with bilateral groin node dissection for a vulvar cancer stage Ib. After 9 months she a local recurrence, which was treated with radiotherapy. An anterior exenteration was performed 8 months later for a second local recurrence. Three months thereafter she had skin metastases at her thighs and calves. Chemotherapy was started; yet the lesions slowly increased. The treatment was discontinued and she died 4 months later.

Skin metastases must be considered a preterminal event with no well-established treatment. They could be caused by retrograde permeation of tumor cells after the destruction of the local draining system.