By Gary M. White, MD
Melanoma of the vulva is rare. 2.6% of melanomas occur in the vulvar region. The typical patient is Caucasian and over 40. There are no classic predisposing factors.
The typical pigmented lesion satisfying the ABCDE criteria may occur. Alternatively, the lesion may be amelanotic, appearing like a "reddish polyp" [Cancer 1999;86;1273]. Associated symptoms can include irritation, bleeding, discharge and lymphadenopathy.
A biopsy large enough to remove the entire lesion (if possible), with adequate depth to allow staging, is recommended. Surgery is the treatment of choice. See melanoma treatment pathway.
A 23 year old woman presented with mass in the vulva for 6 months associated with foul smelling discharge. She was still breast feeding here 7 month old child. Exam showed a friable, fungating mass measuring 6 × 5 cm, involving the anterior and lateral wall of vagina and extending into the vulva. Indian J Surg Oncol. 2012 Mar; 3(1): 36–37
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