Basal cell carcinoma of the vulva

Background and Objectives: Vulvar basal cell carcinoma (BCC) accounts for 7% of all vulvar cancers at two hospitals in the south of Israel. The purpose of this study was to investigate the clinical findings, treatment and outcome of patients with vulvar BCC treated at these institutions. Methods: Data from the files of eight patients with vulvar BCC who were managed at two regional hospitals in the south of Israel (Soroka Medical Center, Beer-Sheva and Kaplan Hospital, Rehovot) between January 1961 and December 1997 were evaluated. Results: Mean age at diagnosis was 70.5 years. A history of other primary cancers was encountered in two patients. Prevailing presenting symptoms were vulvar lump, ulcer, itching, and bleeding. The tumor was most often located on the labium major and its mean size was 2.25 cm. Six patients had wide local excision, one had excisional biopsy, and one had hemivulvectomy. Two patients developed local recurrence and were treated by wide local reexcision and hemivulvectomy, respectively. At follow-up, no patient developed regional and/or distant metastases, or died of BCC. Conclusions: Vulvar BCC is characterized by an indolent behavior with a very low propensity for metastatic spread. The treatment of choice is wide local excision. Because of a substantial risk of local recurrence and high frequency of other primary cancers, close long-term follow-up is essential.