Vulvar basal cell carcinoma

BACKGROUND. Vulvar basal cell carcinoma is a rare neoplasm that often displays aggressive biologic behavior. Recurrence after simple excision is common, and metastases have been reported. Early diagnosis is essential and rests upon histopathologic examination of biopsy specimens, since the clinical appearance of these neoplasms may be deceptively innocent. CASE. A 65-year-old woman was seen with a nonhealing skin lesion on the right vulva. Physical examination revealed a 0.3 x 0.3 cm crusted papule on the right labium majus. A saucerization biopsy was performed. Histopathologic examination of the biopsy specimen revealed basal cell carcinoma. The patient underwent Mohs micrographic excision of the tumor, the total extent of which measured 0.9 x 1.8 cm. CONCLUSION. Vulvar basal cell carcinoma is a rare but important consideration in the differential diagnosis of cutaneous vulvar lesions. Accurate diagnosis depends upon a high index of suspicion, biopsy, and histopathologic examination. Mohs micrographic excision is the treatment of choice. (C) 1997 by the American Society for Dermatologic Surgery, Inc.