Basal cell carcinoma (BCC) is the most common non-melanomatous skin cancer, typically arising in sun-exposed areas such as the head and neck. Defective signaling through the Hedgehog (HH) signaling pathway forms the molecular basis for BCC. Surgery remains the mainstay of treatment. Basal cell carcinoma of the genital tract is rare as is metastatic BCC. We report a case of metastatic BCC in a young woman with previously resected vulval BCC presenting six years later with inguinal nodal recurrence and multiple lung metastases. Highlights ? This case describes a rare case of basal cell carcinoma of the vulva. ? In addition, metastatic spread to the lungs is another rare occurrence. ? Multidisciplinary team discussion is paramount in guiding management. ? Vismodegib is an exciting new treatment option for advanced disease. ? Vigilant monitoring and/or early surgical excision of any suspicious skin lesions is paramount.
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