2026 Volume 44 Issue 2 Pages 153-160
Synopsis: Vulvar cancer is a rare gynecologic malignancy that predominantly occurs in elderly women, although an incidence of 1.7% has been reported among those younger than 35 years. We report a case of vulvar cancer that developed symptoms during pregnancy, was diagnosed postpartum, and showed rapid progression.
A 36-year-old woman developed vulvar pruritus in her second pregnancy. She was treated for genital herpes, but the symptoms persisted. Three months after delivery, she presented with a painful right vulvar mass and inguinal swelling. Biopsy revealed squamous cell carcinoma of the vulva, and she was referred to our hospital. Examination demonstrated an ulcerated right vulvar tumor with bilateral inguinal lymph-node metastasis.
She was diagnosed with stage IVA vulvar cancer. Because surgical resection was considered infeasible, concurrent chemoradiotherapy was administered. However, at the completion of treatment, the disease had progressed, and systemic chemotherapy was subsequently initiated. Despite these treatments, the disease advanced rapidly, and she died seven months after diagnosis.
In young women, ulcerative vulvar lesions are often suspected to be viral infections such as herpes, making early diagnosis difficult. When lesions do not respond to antiviral therapy, malignancy should be suspected, and prompt biopsy is essential, even during pregnancy.
