Presentation
The patient presents with a known vulval mass, abdominal distention and weight loss.
Patient Data
There is an unusual X-ray finding of a large, irregular, lobulated vulval and perineal mass.
The bony pelvis is normal.
The supine chest X-ray demonstrates probable bi-basal pulmonary nodules (left retrocardiac), a possible right upper lobe nodule and a right paratracheal nodule or metastatic lymph adenopathy.
The lung fields are otherwise unremarkable.
There are no bony metastases
There are generalized and significant simple ascites. There is hepatomegaly with diffuse hepatic metastases. The renal tracts remain non-obstructed. There is no obvious intra-abdominal or intra-pelvic lymphadenopathy.
Case Discussion
A case of a suspected stage IVB primary vulval carcinoma with an unusual plain film identification of a locally aggressive and advanced vulval mass lesion.
The positive ultrasound and suspicious chest X-ray findings suggest distant metastases.
The presentation is unusual in a young patient and at work up the patient is found to be HIV positive.
The patient is awaiting staging imaging (CT/MRI).
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