Basal cell carcinoma of the vulva: A report of four cases

Abstract

SUMMARYFour cases of vulval basal cell carcinoma were identified in multiparous females aged 46-78 years. Symptoms included discomfort and pruritus ranging from 6 weeks to 4 years in duration. Such symptoms occurred in the context of a pink vulval plaque. The non-specific symptoms, in the context of the particular anatomical site, led to late presentation. Subsequent treatment in all cases involved wide local excision following incisional biopsy. No recurrence has been documented after a minimum follow-up period of 12 months.

Letters to the Editor

“…All patients underwent computed tomography (CT) of the abdomen and pelvis as a component of screening prior to surgery. 1 The authors make several assertions that we disagree with. In the discussion, the authors recommend the use of this technique, as 'CT scanning improves diagnosis accuracy'.…”

Vulvar basal cell carcinoma with bone metastasis

“…DeAmbrosis et al. 7 treated four vulvar BCC by surgical excision with a 10–15‐mm margin and no recurrence was documented after a minimum follow‐up period 12 months. In general, metastatic BCC is extremely rare, with an average rate of approximately 0.03–0.55% 8,9 .…”

Letters to the Editor

“…Only nine cases of metastatic vulval BCC have been reported, and seven of these cases have metastasized to the inguinal lymph nodes. 1 Based on metastatic BCC prognosis from nongenital sites, a poor prognosis is expected (8 months survival 1 ). CT is therefore indicated to prevent undiagnosed, albeit unlikely, metastatic disease that incurs a vastly different prognosis to localized disease.…”

“…In the discussion, the authors recommend the use of this technique, as 'CT scanning improves diagnosis accuracy'. 1 In their opinion, 'the risk of missing malignant inguinal lymphadenopathy is greater than the very marginal risk of the radiation from the CT scan'. 1 We believe that in medical practice, before carrying out a particular technique, a careful benefit/risk analysis should be performed.…”

“…1 Risk factors that should lead to a higher index of suspicion among clinicians for identifying MBCC include large tumour size, significant tumour depth, previous irradiation, recurrence, immunocompromised patients, and primary BCC of the head and neck. 3,4 Even though higher rates of metastasis occur from primary lesions on the face, scalp and genitalia, MBCC arising from a primary tumour less than 2 cm in diameter is extremely infrequent.…”