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Unusual Locations of Primary Subepithelial Squamous Cell Carcinomas of the Vulva

Scurry, James P. FRCPA1; Yu, Thomas T.2; Otton, Geoffrey R. FRANZCOG3

Journal of Lower Genital Tract Disease: October 2013 - Volume 17 - Issue 4 - p e8–e11
doi: 10.1097/LGT.0b013e31827a8c95
Case Reports

Objective: This study aimed to report 2 cases of squamous cell carcinoma (SCC) of the vulva, arising from unusual subepithelial locations.

Materials and Methods: The first case was of an 85-year-old woman with a 65-year history of a mass in the left labium majus. The second case was of a 54-year-old woman who presented with a 1-week history of a painful left inguinal mass. She had previously sought medical attention for a 2-year history of a left-sided painless vestibular mass.

Results: In the first case, a simple excision showed a purely dermal SCC with no attachment to the epidermis. After the diagnosis of SCC, a wide, deep local excision of the left side of the vulva and left inguinofemoral lymph node dissection were performed. Pathological findings showed no residual tumor in the vulva, and the lymph nodes were clear. Based on the long history of a mass at the same site, the pathogenesis of the SCC was considered to be malignant degeneration of a previously benign epidermal cyst.

In the second case, SCC was diagnosed on fine-needle aspirations of the vulvar and groin masses. The patient was treated with primary chemoradiation. Subsequently, wide, deep local excision of the left side of the vulva and left inguinofemoral lymph node dissection were performed. No residual tumor was found in the vulva, although atrophic Bartholin gland tissue was found at the site of the SCC. One 5-mm inguinofemoral lymph node metastasis was found in the groin node dissection. In the absence of any evidence of another pathogenesis, it was believed that the SCC had arisen from an unusually anterior located Bartholin gland.

Conclusions: Subepithelial SCC should be considered in the differential diagnosis of unusually located vulvar masses.

SCC should be considered in the differential diagnosis of unusually located subepithelial vulvar masses.

1Hunter Area Pathology Service; 2School of Medicine and Public Health, University of Newcastle; and 3Hunter New England Centre for Gynaecologic Cancer Newcastle, New South Wales, Australia

Thomas T. Yu is a medical student from the School of Medicine and Public Health, University of Newcastle.

Reprint requests to: James P. Scurry, FRCPA, HAPS, Locked Bag No 1, Hunter Region Mail Centre, NSW 2310, Australia. E-mail: jamespscurry@gmail.com

The authors have declared they have no conflicts of interest.

Copyright © 2013 by the American Society for Colposcopy and Cervical Pathology