Surgical therapy of vulvar cancer in pregnancy

Squamous cell cancer of the vulva diagnosed and surgically treated during pregnancy is a rare event. Only a few cases have been described until the present. We report two additional women with Stage II and III disease. The first patient, who had a 5 x 2-cm ulcerated lesion under the clitoris was treated by radical anterior vulvectomy and bilateral groin dissection when 22 weeks pregnant. She had an uneventful pregnancy, was delivered by cesarean section, and is free of disease 39 months after initial surgery. The second patient, who had multifocal lesions with a maximal depth of 1.9 mm of tumor invasion underwent modified radical vulvectomy with bilateral groin dissection when 17 weeks pregnant. Because of a grossly positive groin lymph node, she underwent radiation therapy after cesarean section. She is alive without invasive cancer 28 months after diagnosis. Early histological diagnosis and early treatment are mandatory in the management of suspicious vulvar lesions during pregnancy.