Background: Cutaneous metastases from vulvar squamous cell carcinomas (SCC) have been reported only twice previously and both patients expired shortly after they occurred. Mohs surgery has been reported in three previous publications as a successful treatment for local invasive vulvar SCC and Bowen's disease.
Objective: To describe a third case with cutaneous metastases and 14 other cases of invasive and in situ vulvar SCC treated by fresh tissue Mohs surgery in a pilot study at the University of Wisconsin between 1976 and 1995.
Methods: We took photographs of the gross 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 dissection. She expired shortly after the skin metastases appeared. The courses of the patients followed after Mohs surgery for vulvar SCC were variable.
Conclusions: Cutaneous metastases from vulvar SCC are rare but carry a grim prognosis. Mohs surgery should be considered in select cases to try to prevent excess morbidity and mortality.