Background: Adenocarcinoma in the vulva is uncommon, and can be primary or metastatic. Metastatic vulvar adenocarcinoma can derive from a genital primary site: cervix, endometrium, or ovary; or an extragenital site: colorectal, breast, or urinary tract. Cases: In this article 2 patients with metastasis of adenocarcinoma to the vulva are described, with emphasis on differential diagnosis and histology. One patient had a metastasis from a previously unknown and asymptomatic colorectal carcinoma, the other patient had a known cervical adenocarcinoma. In both patients, a metastasectomy was performed. Results:Case 1 was followed-up for more than 2 years and Case 2 for 1 year; no evidence of disease was found in both patients. Conclusions: Clinicians should be aware of the possibility of vulvar metastasis in patients with known primary tumors; new vulvar lesions in these patients should be biopsied to rule out metastatic disease. Second, this article demonstrates that immunohistochemistry can have a role in establishing the primary site when there is no known primary tumor elsewhere. (J GYNECOL SURG 28:43)
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