Patients with vulvar cancer generally have lymphatic metastasis because there are many lymphatic vessels in the perineum, and the capillaries of the lymphatic system are interconnected. Thus, vulvar cancer can lead to bilateral lymphatic vessel spread. Initially, it leads to superficial inguinal lymph nodes, then it spreads to the bone lymph nodes below the groin, and eventually progresses to the lymph nodes alongside the aorta and the lymph nodes below the left clavicle. If the cancer is located in the clitoris, it may bypass the superficial inguinal lymph nodes and directly spread to the lymph nodes inside the pelvis. The tumor in the vulvar area will gradually increase in size; it generally does not invade the muscle fascia or adjacent structures. If the vagina is invaded, it can easily and immediately involve the levator ani muscles, rectum, urethral opening, and bladder, among others.