An Unusual Location of Carcinoma: The Clitoris and the Vulva

Vulvar carcinoma is rare, accounting for less than 5% of all vulvar neoplasms and less than 1% of all neoplasms. Vulvar SCCs are usually diagnosed late because they are often asymptomatic and tend to grow at slow rates. They may be invasive and destructive if neglected or improperly treated. Nevertheless, they have a very low propensity for metastatic spread, but frequently recur after simple excision. We report a 45 year-old woman presenting with the complaint of painful vulvar ulceration ,small swelling at vulvar region and vaginal bleeding. The physical examination revealed a 3 × 2 cm indurated nodulo-ulcerative lesion involving the clitoris, both labia minora and left labia majora. The histopathology was consistent with the “non keratinizing squamous cell carcinoma” that invaded the subcutaneous tissue without lymph node metastasis on left side and with lymph node metastasis on 2 nodes on the right side. The patient underwent wide local excision with clitoral amputation and remained disease free at post-surgical follow-up after 6 months.