Metastatic and secondary tumors of the vulva

Metastatic and secondary tumors of the vulva, though uncommon, were the third largest group of malignant tumors of the vulva at Maternity and Barnes Hospitals. Epidermoid carcinoma of the cervix was the most frequent primary site (46%), followed by the endometrium, kidney, and urethra. Both the primary tumor and the vulvar metastases were diagnosed synchronously in 6 patients (27%). Most patients who subsequently developed vulvar metastases had signs of advanced primary tumor when initially diagnosed. Metastatic adenocarcinoma tended to invade the overlying squamous epithelium, whereas epidermoid carcinoma did not. The frequent occurrence of vascular involvement by metastatic tumor tended to incriminate this as the mode of spread to the vulva. Only 2 patients were alive, 1 with recurrent tumor; the others were dead of tumor usually within 1 year of the diagnosis of a vulvar metastasis.