Bone metastases in vulvar cancer: a rare metastatic pattern

Review of Bone Metastasis in Gynecologic Malignancies: Evaluation and Treatment

OPINION STATEMENT

Metastatic bone disease (MBD) is a significant source of morbidity and mortality in cancer patients with solid tumors, including those with gynecologic malignancies. Infiltration of tumor cells within the bone microenvironment disrupts bone homeostasis and leads to osteoblastic, osteolytic, or mixed bone lesions. Greater than two thirds of those with MBD experience cancer-induced bone pain (CIBP) and one to two-thirds will develop a skeletal-related event (SRE). Various pharmacologic, surgical, and radiation treatments exist for the palliation of bone metastases and the prevention of SREs. It is paramount to understand the diagnostic evaluation and evidence-based treatment paradigms of bone metastases to decrease healthcare utilization, alleviate financial burden, mitigate disability, and improve quality of life.

Rare phalanges soft tissue and bony metastasis in vulvar squamous cell carcinoma: Case report

Vulvar cancer accounts for 0.3 % of new cancer cases within the Unites States. Metastatic vulvar cancer with disease beyond the pelvis is rare and has a poor prognosis. Data on primary treatment including systemic treatments for distant metastatic vulvar disease is limited due to rarity and lack of clinical trials. The purpose of this article is to present an atypical presentation of recurrent vulvar squamous cell carcinoma with metastasis to phalanges soft tissue and bone, clavicle and to the lungs and intracranial space.

FDG-PET/CT of Vulvar Adenocarcinoma With Diffuse Metastases

A 52 year-old woman presented to her gynecologist with a 1-year history of a 1.5-cm left labial mass. Punch biopsy of the vulvar lesion revealed primary infiltrating adenocarcinoma. Staging FDG-PET/CT demonstrated multiorgan diffuse metastases.

A case of isolated ovarian recurrence from vulvar carcinoma

The hematogenous spread from vulvar cancer is extremely rare. We reported an unusual case of ovarian recurrence from vulvar carcinoma. A 78-year-old woman, with a previous (41 months before) diagnosis of vulvar cancer, was admitted to our Institution. Ultrasound revealed a solid mass of the left ovary. Fluorodeoxyglucose positron emission tomography documented an abnormal uptake in the left pelvis. At definitive pathology, the presence of the same histology in vulvar and ovarian mass and the presence of areas of necrosis and endovascular emboli in the ovarian mass led to the diagnosis of ovarian recurrence from vulvar carcinoma. The patient was triaged to salvage treatment and has currently no evidence of disease. This observation expands the range of unusual clinical presentations of recurrence sites from vulvar carcinoma, and emphasizes the need not to underestimate the role of long complete follow-up program in vulvar cancer patients.