A 42-year-old woman presented to her gynecologist complaining of vaginal dryness, dyspareunia, and discharge that had persisted for more than 5 months. Physical exam revealed a 4-cm raised leukoplakic lesion involving the labia minora and perineum. Punch biopsy showed squamous cell carcinoma. She was referred to a gynecology oncologic surgeon for further evaluation. Computed tomography (CT) scan of the chest, abdomen, and pelvis demonstrated tumor involvement of pelvic lymph nodes and tumor expansion...