Vulvar melanoma: relevant aspects in therapeutic management

Campaner, Adriana Bittencourt; Fernandes, Gustavo Leme; Cardoso, Fernanda de Araujo; Veasey, John Verrinder

doi:10.1590/abd1806-4841.20174941

Cited by 13 publications

(9 citation statements)

References 9 publications

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“…The Society for Immunotherapy of Cancer (SIC) recommends adjuvant therapy for patients at increased risk for recurrence [ 1 ]. Prognosis is determined by tumour site, depth of invasion, ulceration, satellite lesions, local extension to the urethra or vagina and lymph node mestastasis [ 6 , 10 ]. The literature demonstrates that 5-year survival rates are around 20-56%, irrespective of stage [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Prognosis is determined by tumour site, depth of invasion, ulceration, satellite lesions, local extension to the urethra or vagina and lymph node mestastasis [ 6 , 10 ]. The literature demonstrates that 5-year survival rates are around 20-56%, irrespective of stage [ 10 ]. The index patient had poor prognostic features which included ulceration, Breslow and Clark level V, positive vaginal excision margins and lymph node metastasis.…”

Section: Discussionmentioning

confidence: 99%

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Malignant nodular melanoma of the vulva: a rare and aggressive tumour of the female genital tract (case report)

Khaba¹,

Lekala²,

Mosehle³

2021

Pan Afr Med J

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Malignant nodular melanoma of the vulva: a rare and aggressive tumour of the female genital tract (case report)

Khaba¹,

Lekala²,

Mosehle³

2021

Pan Afr Med J

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“…A vast majority (80%) of vulvar cancers are squamous cell carcinomas (SCC), whereas basal cell carcinomas (BCCs) and melanomas are less common, representing 8 and 6% of all vulvar cancers respectively (13). Sarco-ma, basal cell carcinoma, and vulvar Paget's disease account for less than 2% of cases (14). The labia major is the most commonly affected site (52%) followed by the labia minor (18%), clitoris (10-15%) and Bartholin´s glands (1-3%) (15).…”

Section: Discussionmentioning

confidence: 99%

Recurrent Vulvar Melanoma – a Case Report

Jovičić¹,

Kesić

Dordević

et al. 2019

Serbian Journal of Dermatology and Venereology

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Melanoma rarely develops in the genital area. It is responsible for 5% of all vulvar malignancies. Postmenopausal women are usually more affected and the main differential diagnosis is vulvar melanosis and vulvar nevi. There are limited numbers of studies on dermoscopic features of mucosal melanoma, particularly early-stage lesions. Dermoscopic criteria have been described for the diagnosis of vulvar melanosis, and observational studies have been conducted to define the dermoscopic features of nevi and melanoma on the vulva. We are presenting the case of a 69-year old female with suspected recurrence of vulvar melanoma who previously had surgical removal of mucosal lentiginous melanoma on the left labia minor in June 2017. Five months after the primary melanoma surgery, the patient noticed de novo pigmentation at the left and right labia minor and urethral opening. On clinical examination, irregular light-brown pigmentation with ill-defined borders was evident on the labia minora of the vulva and around the external urethral orifice. On dermoscopy, irregular pigmented network, with white scar-like and structureless pinkish areas was evident. Incisional biopsy of the vulvar mucosa revealed melanoma in situ, confirming the local recurrence. CT scans of the head, thorax, abdomen and pelvis and gynaecological examination revealed no secondary deposits. Ultrasound of the regional inguinal lymph nodes revealed enlarged suspected pathologic involvement of the lymph nodes in both inguinal regions. Lymph node fine needle aspiration of lymph nodes in the left and right inguinal area revealed pleomorphic infiltrate of lymphoid cells with hemosiderin or melanoma pigment in the cytoplasm. Cystoscopic findings were within normal range. Interdisciplinary tumour board indicated wide excision of melanoma with margins of 1 cm and resection of the urethra, as well as biopsy of the enlarged left inguinal lymph node. Histopathological analysis of the resected mucosa revealed lentiginous spread of melanocytes showing moderate atypia, with focal pagetoid spread, without mitoses and ulceration and without invasion of lamina propria. The resection margins were tumour-free. Non-specific lymphadenitis was diagnosed on lymph node histopathological analysis. The patient was regularly monitored by a dermatologist and urologist, and had no recurrence. The accurate and prompt diagnosis is essential in the case of the vulvar melanoma which has unfavourable and unpredictable prognosis, with a tendency of local recurrences and regional and distant metastases in the case of invasive melanoma. In order not to miss early mucosal melanoma, dermatologists and gynaecologists should not avoid biopsy of lesions that demonstrate any clinical or dermoscopic feature of atypical melanocytic lesion, especially in case of the development of irregular pigmentation that expands and changes over time, the appearance of a solitary amelanotic papule or nodule requires excision or, in case of large diameter lesions, incision biopsies. Larger studies are needed to define more rigorously clinical and dermoscopic criteria that accurately distinguish early mucosal melanomas from benign skin lesions.

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“…Даже в современных монографиях и сводках по морфологии иммунной системы данный вопрос не рассматривается [1]. Это, с одной стороны, не способствует созданию целостной картины по вопросам структуры и функции иммунной системы в целом, с другой -не благоприятствует разработке новых схем профилактики и многочисленных заболеваний влагалища [2,3].…”

Section: Introductionunclassified

Cellular composition and microanatomy of lymphoid formations of the vestibule of the vagina in postnatal ontogenesis

Shadlinskaya

2019

jour

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Aim - presents data on the number of cells of the lymphoid series and the cellular composition of the lymphoid tissue in the mucosa of the vaginal vestibule at diﬀerent age periods of ontogenesis. Materials and methods. The study material was preparations of the vaginal vestibule taken from 45 women of diﬀerent ages (from newborns to 75 years). By age periods, the material was subdivided according to the standard scheme of age periodization. Cross sections of the organ wall were stained with hematoxylin - eosin and according to Van Gieson. In a number of cases, the silvering of Grimelius was performed. Obtained during the study of digital data were subjected to statistical processing. Results. Analysis of the results showed that lymphoid formations are located mainly near the glands. Glandular - lymphoid relationships are less impressed in newborns, to the maximum extent from early childhood to the 1st period of adulthood, in the elderly and senile age of cells. There are fewer lymphoid rows near the initial divisions and in the stroma of the glands. The lymphoid apparatus of the vaginal vestibule is represented by all the morphogenetic forms of the lymphoid tissue. The qualitative composition of lymphoid tissue is of the same type in all its morphogenetic forms, regardless of age. It has been established that there are close microsynthopic connections between immune structures and small glands of the vestibule. The intensity of these relationships has ontogenetic features. They are relatively weak in new - borns, are maximal in early childhood and weaken after the 1st period of adulthood. Conclusion. The study allowed us to identify previously unknown patterns of morphogenesis of lymphoid structures of the vaginal vestibule.

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Vulvar melanoma: relevant aspects in therapeutic management

Cited by 13 publications

References 9 publications

Malignant nodular melanoma of the vulva: a rare and aggressive tumour of the female genital tract (case report)

Malignant nodular melanoma of the vulva: a rare and aggressive tumour of the female genital tract (case report)

Recurrent Vulvar Melanoma – a Case Report

Cellular composition and microanatomy of lymphoid formations of the vestibule of the vagina in postnatal ontogenesis

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