Unusual vulvar cancer recurrence after radical vulvectomy with negative margins: a case report

Introduction: The most common type of vulvar cancer is squamous cell carcinoma. The management of early-stage vulvar squamous cell carcinoma includes radical local excision of the primary tumor. Evaluation of sentinel nodes for metastases is used for diagnostic and prognostic purposes. Presentation of case: We present the case of a 62-year-old patient, with a history of radical vulvectomy with inguinal lymphadenectomy due to vulvar cancer 7 months prior to presentation and found to have new suprapubic lesions – 10 cm above the pubic bone. Results showed recurrence of the primary tumor despite negative results of margins and lymph nodes. The patient was then transferred to a Hemato-Oncologist for further management. Conclusion: In spite of the negative results, the patient presented for unusual recurrence 10 cm above the pubic bone, rather than locally or in the groin area. This raises questions about the mechanism of recurrence and preventative measures to be taken.