Introduction/Background Breast cancer is the most common type of cancer and the most common cancer-related cause of death in women. In general, breast cancer metastasises to regional lymph nodes, lungs, bones, liver and brain, and more rarely to gynecological organs such as the uterus or ovaries. A rarity are metastases of the vulva, especially in isolated form. In the following, an intriguing case of a postmenopausal, 61-year-old female patient with an isolated breast cancer metastasis of the vulva, which occurred 13 years after the initial breast cancer diagnosis, is reported.

Methodology In 2019, the patient presented herself in our dysplasia unit with pruritus of the vulva with punctum maximum at the right labia majora. After the patient was treated for breast cancer in 2006, she neglected follow-up care recently. The gynecological examination, including vulvoscopy, showed a suspicious area with an ulceration beginning at the right labia majora. A punch biopsy was performed. The staging examination with CT scans of the thorax and abdomen, as well as a bone scintigraphy, revealed no further metastases.

Results The isolated metastasis of the vulva was excised surgically by resection of the right labia majora. Postoperatively, an adjuvant therapy with a CDK4/6 inhibitor in combination with an aromatase inhibitor was recommended.

Conclusion This unusual pattern of a metastatic disease highlights the importance of regular gynecological examinations during follow-up in breast cancer survivors and strengthens their unreserved recommendation. Unusual metastasic patterns after long, disease-free intervals can thus be diagnosed and treated at an early stage.

Disclosure Nothing to disclose.