A 33-year-old Hispanic woman presented to the dermatology service for evaluation of a slowly growing nodule in her left inguinal region. She had undergone surgical resection of a mass on her left labium majus 10 years ago and had had surgery for a recurrence 3 years ago. Most recently, she had noticed reappearance of an asymptomatic growth at the previous surgical site.
Dermatologic examination revealed a 2-cm soft erythematous nodule with slightly lobulated surface and small central erosion on the superior aspect of the left labium majus that appeared to be fixed to the underlying subcutaneous tissue. No inguinal lymphadenopathy was appreciated. A 4-mm punch biopsy specimen was obtained from the center of the lesion and sent for pathologic examination (Figures 1, 2, and 3).