title: Vulvar metastases secondary to transitional cell carcinoma of the bladder. A case report.
abstract: BACKGROUND
  Gynecologists are frequently asked to evaluate patients with vulvar lesions. Although the differential diagnosis of a vulvar lesion is varied, the main concern is to rule out a vulvar malignancy. Primary vulvar carcinoma is uncommon, and a metastatic cancer from an extragenital site involving the vulva is even more rare.
  
  
  METHODS
  A 78-year-old woman with a history of a transitional cell carcinoma (TCC) of the bladder presented with two painful vulvar lesions, which represented the first manifestation of metastatic disease. This is the fifth reported case of TCC from the bladder with metastases to the vulva.
  
  
  CONCLUSIONS
  The differential diagnosis of a vulvar lesion, especially in a woman with a prior history of renal tract malignancy, should include metastatic lesions.
authors.affiliation: Department of Urology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA.
authors.forename: L B
authors.initials: LB
authors.lastname: Lerner
authors.forename: S J
authors.initials: SJ
authors.lastname: Andrews
authors.forename: J L
authors.initials: JL
authors.lastname: Gonzalez
authors.forename: J A
authors.initials: JA
authors.lastname: Heaney
authors.forename: J L
authors.initials: JL
authors.lastname: Currie
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000556:secondary*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D001749:Urinary Bladder Neoplasms / Q000473:pathology*; D014846:Vulvar Neoplasms / Q000175:diagnosis / Q000556:secondary*