Unusual Presentation of Vaginal Squamous Cell Carcinoma in Older Woman With Hyperarousal and Unwanted Orgasms

Vaginal squamous cell carcinoma is a rare gynecologic malignancy that typically presents with nonspecific symptoms, such as abnormal vaginal bleeding, discharge, and pelvic pain. It most often arises in postmenopausal women and is strongly associated with persistent high-risk human papillomavirus infections. Here, we discuss a unique case of an 87-year-old woman who presented with spontaneous orgasmic sensations. Pelvic magnetic resonance imaging revealed a vaginal mass and necrotic inguinal lymph node; biopsy confirmed squamous cell carcinoma. This case highlights considering vaginal cancer in postmenopausal women with atypical sexual symptoms.