Carcinosarcomas (CS) are exceedingly rare in the vulva, with only 3 cases reported in the English literature, associated with squamous cell carcinoma (2) or spiradenocarcinoma (1). We first report a vulvar CS with intestinal-type mucinous adenocarcinoma associated with anaplastic pleomorphic and spindle cell carcinoma and heterologous chondro- and osteosarcomatous elements in a 62-year-old woman, who presented with a painless, slow-growing vulvar cyst for almost 2 years, that rapidly enlarged and hardened in the last 4 months forming a mass. The tumor was widely excised, but recurred 2 months later, and she died 2 months after recurrence. A review on this entity is performed highlighting its morphologic and immunohistochemical features, and discussing issues in nomenclature and potential origins within the vulva.