Purpose of Investigation: Stage IA vulvar cancer with a depth of stromal invasion less than 1 mm is generally managed by wide local excision alone since there is less than 1% risk of lymph node involvement. Case: A 62-year-old patient was admitted to a university hospital with a suspicious vulvar lesion. Results: We present the first case of inguinal node and a possible contralateral pubic minus recurrence following bilateral superficial inguinal lymphadenectomy and wide local resection for Stage IA vulvar cancer. Conclusion: There is no evidence that extended radical surgery provides a better overall survival or reduces recurrence rate in Stage IA vulvar carcinomas. Conservative vulvar resection and sentinel node dissection seem to be a rational choice. Nevertheless the disease may recur in the inguinal areas and frequently be lethal, therefore close surveillance and early attempts to treat the recurrent disease before infection and inflammation ensues should be the aim of current treatment strategies.