[Clinical Picture] A growing vulvar mass in a post-menopausal woman

In March, 2020, a 62-year-old postmenopausal woman (gravida 2, para 2) presented at Sunnybrook Health Sciences Centre (Toronto, ON, Canada) with a 1-year history of a growing vulvar lesion, without any bleeding or discomfort. A firm, mobile, vulvar mass approximately 2 cm in size was evident on physical examination; the cervix appeared normal. A biopsy revealed tumour nests and cords extensively infiltrating the dermis, but no tumour in the epidermis. By immunohistochemistry, the tumour cells stained for CK7 but not for CK20, supporting the morphological impression of adenocarcinoma.

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