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I am aware that scons implements the functionality of ccache, but I am stuck with another build system.
I also know there is a gocache project on SourceForge that aims to implement ccache-like functionality for other compilers, but it seems not complete.
Stashed
It supports PDB, PCH, and has a nice dashboard.
Disclaimer: I'm one of the authors :)
Incredibuild is very nice, though it is more like distcc for Visual Studio than ccache.
If you want both ccache and distcc for a Visual Studio environment, try Stashed along with Incredibuild at the same time. It works a lot like ccache + distcc for Linux, without the configuration or administrative overhead.
https://github.com/inorton/cclash
It is a bit more of a plug. I've been using it to shave about 35% off our Cygwin Visual Studio 2012 builds.
There's an unofficial patch to ccache to support MSVC, but I haven't yet tried it myself...
A shameless plug, but I wrote a Python script which attempts to work just like ccache, except that it can wrap MSVC. See https://github.com/frerich/clcache