Amelanotic Vulvar Melanoma

Abstract

A 14-year-old girl stated that she has vulvar pruritus, pain, and bleeding and underwent a complete gynecological evaluation during which a suspicious 2-cm achromic lesion on her vulva was observed. Initially, it was suspected to be a pyogenic granuloma, in relation to the patient's age. A biopsy was taken, and a histopathological diagnosis of amelanotic mucosal melanoma was made. Pyogenic granuloma is a reactive hyperproliferation vascular response to trauma or other stimuli. It predominantly occurs in the second decade of life in young females, in relation to the vascular effects of female hormones. Primary mucosal melanoma is a rare and aggressive neoplasm, characterized by a higher aggressiveness and a worse prognosis than her cutaneous counterpart. The female genital tract is the second most common site of onset of mucosal melanoma; it represents the 3% of melanomas diagnosed in women.

A Scoping Review and Population Study Regarding Prevalence and Histopathology of Juvenile Vulvar Melanocytic Lesions. A Recommendation

“…We discerned eight publications with case reports of vulvar melanomas in girls aged 9‒18 years encompassing, in all, nine patients ( Egan et al., 1997 ; Filippetti and Pitocco, 2015 ; Friedman et al., 1984 ; Hassanein et al., 2004 ; Hulagu and Erez, 1973 ; La Spina et al., 2016 ; Rosamilia et al., 2006 ; Webber et al., 2008 ), six with concomitant VLS and three without. No recurrence or metastasis was reported.…”

Clinician’s Update on the Benign, Premalignant, and Malignant Skin Tumours of the Vulva: The Dermatologist’s View

“…A vulvar melanoma is characterised by an asymmetrical black macule, papule, or nodule often with an irregular border and with a diameter larger than 7 mm located on the mucosal surface most frequently on the labia majora, labia minora, or the clitoral hood [ 47 , 69 ]. Vulvar amelanotic melanoma is an erythematous lesion without the typical characteristics of melanoma which may imitate a pyogenic granuloma [ 70 ]. Dermoscopy may facilitate early identification of a melanoma suspect lesion with irregular dots and globules, multiple colours (black, blue, brown, pink, gray, and white), a blue-white veil, and atypical vessels [ 71 ].…”

Melanoma of vulva in situ, presentation of a case

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BackgroundMelanoma of the vulva is the second most common type of vulvar cancer. [1][2][3][4][5][6][7][8][9][10] Malignant melanoma develops from melanocytes, these are cells that contain melanosomes, and are found in the basal layer of the epidermis, which synthesize and transform the melanic pigment, with the skin being the most common site (90-91%). it also develops in the mucosa (1.3%) as in the nasal cavity, anus, vagina, and vulva.

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“…2,[4][5][6][7] Ulcer formations, previous local radiation, human papillomavirus infection, diabetes mellitus, or immunosuppression are all predisposing factors. [6][7][8][9] The prognosis for vulvar melanoma is very poor with a 5-year survival ranging from 8-55% compared to 50-80% 5-year survival in other cutaneous melanomas. 1,4 The main prognostic factors include AJCC stage, Breslow thickness, tumor location, tumor thickness, ulceration, clinical melanosis, and lymph node status.…”