Recurrent vulvar carcinoma in pregnancy

Vulvar carcinoma is rare in the premenopausal age group. The incidence during pregnancy is even more uncommon. To date, no cases of recurrent vulvar carcinoma in pregnancy have been reported. We describe the first case of recurrent vulvar carcinoma during the same pregnancy. A 36-year-old G5P4004 presented with vulvar pain at 18 weeks of pregnancy. She had a 2.2-cm tender mass anterior to the left labium majus, of which a biopsy revealed invasive squamous cell carcinoma. At 23 weeks' gestation, she underwent a modified radical vulvectomy and bilateral inguinofemoral lymph node dissection. Eleven weeks later, she complained of a newly tender area to the right of the clitoris. A biopsy at that time demonstrated predominantly severe vulvar intraepithelial neoplasia (VIN III) with a small focus of invasive squamous cell carcinoma. A radical local excision was performed at 9 weeks postpartum. Careful surveillance is warranted as squamous cell carcinoma recurrence can occur quickly in the setting of pregnancy.