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Delayed presentation of a giant vulvar squamous cell carcinoma in a low-resource setting: a case report
Isaac Marfo1,2, Lawson Odere1,2, Alfred Secha1,2
1Department of Obstetrics & Gynaecology, Muhimbili National Hospital, Dar es Salaam, Tanzania.
Introduction And Importance:
Vulvar squamous cell carcinoma (VSCC) is the most common vulvar malignancy and is typically diagnosed at an early stage. However, delayed presentation in low-resource settings may result in advanced disease, requiring complex management.
Presentation Of Case:
We report a 47-year-old woman with a 2-year history of a progressively enlarging vulvar mass. Examination revealed a giant exophytic tumor (22 × 15 × 12 cm) with bilateral inguinal lymphadenopathy. Magnetic resonance imaging showed no invasion of adjacent structures. Histopathology confirmed Grade 1 VSCC with nodal metastasis (FIGO stage III). The patient underwent wide local excision with bilateral inguinofemoral lymph node dissection and reconstruction using gracilis myocutaneous flaps. She received adjuvant chemotherapy but was lost to follow-up after four cycles.
Clinical Discussion:
Delayed presentation contributes to advanced disease. Socioeconomic and healthcare access barriers influence both diagnosis and treatment adherence.
Conclusion:
This case highlights the consequences of delayed presentation and the need for improved access to early detection and care.