Breast cancer metastatic to the vulva

Primary cancer of the vulva is not common, constituting only 3-5% of all gynecologic malignancies and <1% of all cancer in the female. Metastatic tumors of the vulva are even more unusual, constituting only 5-8% of all vulvar cancers.

A 32-year-old female underwent total mastectomy with axillary lymph node dissection for left breast cancer. The patient was well with a postoperative follow-up period of 40 months till a 1.2-cm lump was noted in her left labium majus. Excisional biopsy was performed and histologic examination was done. Pathologic examination of the breast cancer revealed coexistence of intraductal carcinoma and invasive lobular carcinoma. The histologic feature of the invasive lobular carcinoma was consistent with that of the vulvar lesion. The vulvar cancer was consistent with a metastatic lobular carcinoma from the breast.

Only with careful gynecologic surveillance in women with breast cancer can the unusual sites of metastasis be detected earlier and appropriately treated.