Introduction: Uncommon tumor, that accounts for 3-5% of all gynecological malignancies. Most commonly seen in postmenopausal women. 90% accounts to SCC. Although external in location, hesitancy results in delayed diagnosis.

Case report: 64 year old P4L3 postmenopausal woman with no known comorbidities, was admitted with multiple episodes of vomiting, irrelevant talk, generalised weakness. Incidentally, a swelling was noted over external genitalia. of size 4x3cm over left labia majora. Vulval biopsy showed Squamous Cell Carcinoma of Vulva. She underwent Total Abdominal Hysterectomy + B/L Salpingo ophorectomy + Appendicectomy + left inguinal lymphnode dissection followed by Modified Radical Vulvectomy. Lymphatics both superficial and deep femoral were dissected. HPE of the specimen showed SCC of vulva-moderately differentiated, SCC insitu of cervix, superficial spreading type extending up to endometrium, following which Adjuvant chemoradiation of dose 54 Gy in 27 fraction along with 5 cycles of weekly Injection Cysplatin was given starting from 1 month post surgery.

Conclusion: Synchronous primary genital cancer is an uncommon occurrence. In this case, additional association with Empty Sella Syndrome makes the management even more complex.