Abstract

Vulvar cancer is uncommon, accounting for only 5% of gynecological malignancies and primarily
affecting postmenopausal women. Basal cell carcinoma (BCC) of the vulva accounts for less than
1% of all BCCs and though rare cases arise in sun-protected areas. Among the types of BCC, the
most common type is nodular. While the superficial and nodular BCCs are slow-growing tumors,
the aggressive BCCs are infiltrative, desmoplastic tumors. We describe a case of a 25-year-old
female with vulvar BCC that was presented as an ulcerated mass lesion in the right labium majus.
After biopsy, the histopathology results showed BCC, mixed nodular and infiltrative type with focal
areas of squamous metaplasia confirmed by IHC staining. This clinical case reports an atypical
presentation and unique histopathology of genital lesions to aid in future differential diagnosis and
treatment. Vulvar BCCs remain a rare tumor of the vulva, which has excellent prognosis if managed
appropriately. Therefore, any persistent lesion in the vulvar region should be examined
histologically regardless of the patient age. Clinicians should perform a detailed examination of
patients presenting with these lesions, as vulvar BCCs can easily be misdiagnosed due to its
similarity to common benign lesions and others cutaneous genital pathologies on the vulva.