Quality metric = 28S to 18S: 1.6 Patient Age: 50-60 Gender: Female Ethnic Background: American Indian Tobacco Use : Yes Type of Tobacco Use: Cigarettes Alcohol Consumption?: No Family History of Cancer?: No Days from Patient Diagnosis to Excision: 2 Pathological T: 4 Pathological N: X Pathological M: 1 Pathological Metastatic Sites: Hepatic Pathological Stage: 4B Pathological Grade: 3 Primary Site: Vulva Histology: Metastatic Squamous cell carcinoma