No abstract

Malignant melanoma of the vulva in childhood is a rare neoplasm. Lichen sclerosus of the vulva in childhood is also a rare disease. The association of these two rare lesions in the vulva of young girls is extremely rare. We present a 10-year-old white girl with malignant melanoma associated with lichen sclerosus of the vulva. She had dark pigmentation of both the labia minora and posterior fourchette. The inner labia majora and fourchette showed whitish, glistening areas of skin. Histologic examination found mostly an in situ lentiginous/mucosal melanoma with focal invasion to a depth of 0.44 mm in the left upper labium majus. All specimens showed evidence of lichen sclerosus. Partial vulvectomy was performed, and no metastases were detected at the time of treatment. The patient has been disease free for the 12 months after treatment. It is critical for physicians to realize that melanoma can occur in children, and although rare, can occur in the vulva. We feel that lichen sclerosus in this instance may represent a pattern of host immune response to melanoma.

This is a retrospective analysis of 264 patients with Stage IB and IIA‐B carcinoma of the cervix treated with curative intent at the University of Florida from October 1964 through April 1980. There is a minimum 2‐year follow‐up. Patients dead of distant metastases (13), dead from intercurrent disease (14), or lost to follow‐up (1) less than 24 months from treatment with pelvic disease controlled were excluded from analysis of pelvic control. All patients were included in analysis of complications and survival. Tumor size and hematocrit were noted to be significant prognostic factors with regard to control of disease in the pelvis in Stage IB and IIA cancers. Tumor size and hematocrit also influenced pelvic control in Stage IIB, but to a lesser extent than in Stages IB and IIA. Patient age was a weak prognostic factor for control of disease in the pelvis for Stages IB, IIA, and IIB, but more strongly influenced pelvic control when considered in conjunction with tumor size and hematocrit. Overall treatment time influenced pelvic control in all cases when the size of the lesion was ≧6 cm. in lesions ≧6 cm in diameter, the amount of tumor regression noted at the time of the radium application after 3500 to 4000 rad external beam irradiation was a predictor of pelvic control. Data on treatment complications and survival are included, and future treatment strategies discussed.