Epidermotropic metastasis from vulvar squamous cell carcinoma: A rare cutaneous manifestation

Cutaneous metastases occur in 0.7% to 9% of all malignancies. In women, cutaneous metastases occur most often in breast cancer, followed in order by colorectal carcinoma, melanoma and ovarian carcinoma. Of the squamous cell carcinomas (SCC) that do metastasize, many are exceedingly difficult to differentiate from primary SCC of the skin and are often found in the advanced stages with well-established primary tumor and lymph node involvement. This is an important distinction because metastatic cutaneous SCC is associated with a much poorer prognosis than primary SCC. Cutaneous metastases from vulvar cancers are even less common and have been reported in only 8 cases. We report a rare case of epidermotropic metastatic squamous cell vulvar cancer in a 77-year-old woman.