Breast-like Vulvar Lesion with Concurrent Breast Cancer: A Case Report and Critical Literature Review

In the current report, we describe an intriguing case of a breast-like cancer lesion located in the vulvar region in a woman lacking a remarkable past medical or family history of breast cancer but with concurrent breast cancer. Consequently, a differential diagnosis between a primary synchronous breast and vulvar cancer or a metastatic breast carcinoma to the vulva is a key point in terms of the clinical approach. In a review of the literature, 39 cases of breast-like cancer lesion have been described: 23 cases of primary infiltrating carcinoma of the vulva and 16 cases of vulvar metastases of breast carcinoma. To the best of our knowledge, this is the first report of a clinically synchronous vulvar metastasis from an invasive ductal carcinoma. The main diagnostic criteria for differential diagnosis between primary or metastatic breast-like vulvar carcinoma are also discussed. Here we describe a case of a breast-like vulvar cancer lesion in a patient with a concurrent breast cancer. Metastases from breast cancer, the most common malignancy and the leading cause of cancer-related death in women, usually occur in the axillary lymph nodes, lungs, bone, liver and brain in descending order of frequency (1). Involvement of the female reproductive tract is rare. When it does occur, the ovaries and uterus are the most frequently reported sites (2). On the other hand, it has been proposed that ectopic breast tissue can occur anywhere along the primitive 'milk line', extending from the axilla to the vulva (3). Such ectopic tissue may undergo the same physiological and pathological processes found in the normal breast. In the present paper, we discuss the differential diagnosis between primary breast- like carcinoma of the vulva and metastatic vulvar lesion of primary breast cancer on the basis of the literature review.