Malignant melanoma of the vulva is a rare and aggressive tumour with dismal prognosis. It tends to recur and metastasize early. Surgical excision with or without regional lymph node dissection is still the treatment of choice with adjuvant therapy decided on a case by case. Furthermore, HIV infection has been associated with more aggressive disease. Herein we present a 45-year-old HIV-infected female patient on antiretroviral therapy who presented with vulval ulcer for one year. On examination, she had ulcerated nodule on the labia majora. Radiology showed vulvovaginal tumour without involvement of the adjacent organs. Malignant melanoma was confirmed on both the incisional biopsy and vulvectomy. She responded poorly to radiotherapy. Furthermore, she presented with recurrence and metastatic disease a month after surgery. She was lost to follow-up clinic.
The goal of the study was to assess the feasibility of Laparoscopic Minimally Invasive Inguinal Lymph Node Dissection (L-MILND) for carcinoma of the vulva where sentinel lymph node biopsy could not be done. Laparoscopic Minimally Invasive Inguinal Lymph Node Dissection (L-MILND) is a procedure developed to decrease morbidity associated with inguinal lymphadenectomy while maintaining acceptable oncological outcomes. Initial experience and feasibility of this technique at the authors' institution is reported.
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