Vulvar keratinizing squamous cell carcinoma in a 26-year-old woman

A 26-year-old Hispanic woman complaining of "itching" and "herpetic lesions " on the vulva for 9 months was seen at a university hospital. On physical examination, multiple vulvar masses were noted. Biopsies taken from these l esions showed invasive keratinizing squamous cell carcinoma. The vulvectomy specimen revealed 4 tumor masses, the largest located on the mons pubis. A lthough the incidence of vulvar intraepithelial neoplasia has increased in recent years, only very few cases of invasive carcinoma have been reported in young women. The tumors that occur at a younger age characteristically h ave basaloid or warty histology, in contrast to those occurring in older wo men, which usually are well-differentiated keratinizing carcinomas. We beli eve this is an unusual case of vulvar squamous cell carcinoma. In addition to our patient's young age, her tumor had a histologic profile usually foun d in lesions of an elderly woman. The tumor was negative for human papillom avirus by polymerase chain reaction analysis and was positive for p53 by im munohistochemistry.