VULVAR SQUAMOUS-CELL CARCINOMA METASTATIC TO THE SKIN

BACKGROUND. Cutaneous metastases from vulvar squamous cell carcinomas (SCC) have been reported only twice previously and both patients expir ed shortly after they occurred. Mohs surgery has been reported in thre e previous publications as a successful treatment for local invasive v ulvar SCC and Bowen's disease. OBJECTIVE. TO describe a third case wit h cutaneous metastases and 14 other cases of invasive and in situ vulv ar SCC treated by fresh tissue Mohs surgery in a pilot study at the un iversity of Wisconsin between 1976 and 1995. METHODS. We took photogra phs of the guess appearance and of the histologic slides of the tumor at the local site and at the metastatic sites on the skin and reviewed patients' charts. RESULTS. One patient developed pelvic and cutaneous metastases 5 years after radical vulvectomy with bilateral node disse ction. She expired shortly after the skin metastases appeared. The cou rses of the patients followed after Mohs surgery for vulvar SCC were v ariable. CONCLUSIONS. Cutaneous metastases from vulvar SCC are rare bu t carry a grim prognosis. Mohs surgery should be considered ir I selec t cases to try to prevent excess morbidity and mortality. (C) 1998 by the American Society for Dermatologic Surgery, Inc. Dermatol Surg 1998 ;24:889-892.