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ologic high grade which confers poor prognosis and reduced chances for good overall survival outcome. To evaluate the incidence of pulmonary metastases in the preoperative work-up of patients with primary vulvar squamous cell carcinoma (SCC). Retrospective cohort study. Tertiary referral centre. Patients treated for primary vulvar SCC from 2000 to 2018. The pre-operative chest imaging of 452 consecutively treated patients was documented with a minimal follow-up period of 2years. Incidence of pulmonary metastases, f