title: Skin metastases from vulvar cancer: a fatal event.
abstract: BACKGROUND
  Cutaneous metastases from a vulval cancer are exceptional with only 4 reported cases in the literature.
  
  
  METHODS
  The present case is a patient who had a radical vulvectomy with bilateral groin node dissection for a vulvar cancer stage Ib. After 9 months she a local recurrence, which was treated with radiotherapy. An anterior exenteration was performed 8 months later for a second local recurrence. Three months thereafter she had skin metastases at her thighs and calves. Chemotherapy was started; yet the lesions slowly increased. The treatment was discontinued and she died 4 months later.
  
  
  CONCLUSIONS
  Skin metastases must be considered a preterminal event with no well-established treatment. They could be caused by retrograde permeation of tumor cells after the destruction of the local draining system.
authors.affiliation: Department of Gynecological Oncology, University Hospital, Antwerp, Belgium. wiebren.tjalma@uza.be
authors.forename: Wiebren Age A
authors.initials: WA
authors.lastname: Tjalma
authors.forename: Kristien
authors.initials: K
authors.lastname: Watty
mesh_terms: D000368:Aged; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy / Q000601:surgery; D012878:Skin Neoplasms / Q000188:drug therapy / Q000556:secondary*; D014846:Vulvar Neoplasms / Q000473:pathology* / Q000601:surgery