Secondary Tumors of the Vulva: A Six-Case Retrospective Series and Narrative Review

Background: Within gynecological oncology, vulvar metastases represent an exceptionally rare clinical entity, accounting for 5% to 8% of all observed vulvar lesions. Secondary vulvar tumors usually reflect advanced metastatic disease and are associated with poor prognosis. This study describes the clinical and morphological characteristics of metastatic vulvar neoplasms and compares them narratively with previously reported cases and primary vulvar malignancies. Methods: We conducted a retrospective review of institutional medical records spanning from 2013 to 2021. The study specifically selected patients diagnosed with metastatic vulvar neoplasms whose predominant initial symptom and primary reason for medical consultation was the development of localized vulvar lesions. Results: During the specified study period, 6 distinct cases of metastatic disease were identified, comprising merely 2.33% of the total vulvar neoplasm cases evaluated at our institution. Anatomically, 83.3% of these metastatic lesions were localized on the vulvar lips. Clinical presentation was evenly distributed, with 50% of patients presenting with a solitary lesion and 50% exhibiting multiple lesions. Prognostic outcomes were overwhelmingly unfavorable; only 1 patient survived beyond one year of continuous medical treatment. Conclusions: Our analysis suggests that several critical clinical parameters can effectively guide the timely differential diagnosis of metastatic vulvar lesions. These key clinical markers include the patient’s age at presentation, the physical extent of the lesion, the number of tumors present, associated localized or systemic symptoms, and the critical presence of other concurrent metastatic sites confirmed via imaging.