This is the case of an 81 year-old G4P4 (4003), a diagnosed case of Paget's disease of the vulva, who underwent wide local excision a year prior to present admission. A year after her initial vulvar surgery, she developed a presumed recurrence of the Paget's disease in the right groin area extending to the supero-anterior aspects of the right thigh and right aspects of the mons pubis. She underwent a repeat local excision, superficial groin node biopsy and abdominal rotation flap but final histopathology revealed a vulvar adenocarcinoma, a completely different histology from the pathology a year ago, despite a side-by-side review of the two microscopic specimens. Clearly, a case of the two metachronous tumors of the vulva developed in the patient.