Vulvar nevi, melanosis, and melanoma: An epidemiologic, clinical, and histopathologic review

Cancer of the vulva accounts for at least 1% of malignant neoplasms among women. Although rare, vulvar melanoma is the second most common histological type of vulvar cancer, representing 7-10% of all malignant vulvar neoplasms. Initial symptoms are non-specific and complete excision of the lesion is indicated in cases with suspected diagnosis. Prognosis of patients with these neoplasms is poor and remains unchanged despite the treatment approach. Hemivulvectomy with lymph node dissection is the current procedure of choice, associated or not with adjuvant therapies. We report two cases of patients presenting with late diagnosed vulvar melanoma and the relevant aspects in their therapeutic management.

show abstract

“…Given that lesion size is a determinant for prognosis, early detection of the tumor is of vital importance. 4,5 …”

Section: Introductionmentioning

confidence: 99%

Vulvar melanoma: relevant aspects in therapeutic management

Campaner

Fernandes

Cardoso

et al. 2017

An. Bras. Dermatol.

View full text Add to dashboard Cite

show abstract

“…Melanosis, also called melanotic macule and mucosal‐pigmented macule, is a benign pigmentation of the mucosa, corresponding to hyperpigmentation of basal keratinocytes with possible slight proliferation of melanocytes at the epithelial‐chorion junction (ECJ). It is the most common cause of mucosal pigmentation and can be clinically difficult to differentiate from early melanoma (MM), especially when occurring on genitalia . In fact, in this special body site, melanosis can reveal worrisome clinical features, as multiple, asymmetric macules or patches with variable colour and irregular and poorly demarcated borders .…”

Section: Introductionmentioning

confidence: 99%

In vivo confocal microscopic substrate of grey colour in melanosis

Cinotti

Couzan

Perrot

et al. 2015

Acad Dermatol Venereol

View full text Add to dashboard Cite

Our findings highlight that the presence of the grey colour on dermoscopy, considered as an alerting feature, is common in melanoses and it is related to the presence of melanin-laden inflammatory cells in the papillary dermis on RCM. When it is present as a 'pure' feature not associated to other colours than brown or to atypical dermoscopical structures, it could be related to the diagnosis of melanosis.

show abstract

“…The incidence is slightly higher in Caucasians compared to Hispanics, Asians, Blacks, and American-Indians [5]. Risk factors include chronic inflammation, such as that associated with lichen sclerosis [6]. The differential diagnosis of pigmented vulvar lesions includes vulvar nevi and vulvar melanosis (also referred to as vulvar lentiginosis or vulvar melanotic macule), particularly in younger individuals.…”

Section: Resultsmentioning

confidence: 99%

“…Their colors range from red to dark brown-black and they typically measure less than 1 cm. Vulvar melanosis is characterized by single or multiple, irregularly pigmented, tan to black macules or patches with uneven borders [6]. …”

Section: Resultsmentioning

confidence: 99%

Early diagnosis of genital mucosal melanoma: how good are our dermoscopic criteria?

Rogers

Pulitzer

Marino

et al. 2016

Dermatol Pract Concept

View full text Add to dashboard Cite

BackgroundThere are limited studies on the dermoscopic features of mucosal melanoma, particularly early-stage lesions. Described criteria include the presence of blue, gray, or white colors, with a reported sensitivity of 100%. It is unclear if these features will aid in the detection of early mucosal melanoma or improve diagnostic accuracy compared to naked-eye examination alone.CaseAn Asian female in her fifties was referred for evaluation of an asymptomatic, irregularly pigmented patch of the clitoral hood and labia minora of unknown duration. Her past medical history was notable for Stage IV non-small cell lung cancer. She denied a personal or family history of skin cancer. Dermoscopic evaluation of the vulvar lesion revealed heterogeneous brown and black pigmentation mostly composed of thick lines. There were no other colors or structures present. As the differential diagnosis included vulvar melanosis and mucosal melanoma, the patient was recommended to undergo biopsy, which was delayed due to complications from her underlying lung cancer. Repeat dermoscopic imaging performed three months later revealed significant changes concerning for melanoma, including increase in size, asymmetric darkening, and the appearance of structureless areas and central blue and pink colors. Histopathological examination of a biopsy and subsequent resection confirmed the diagnosis of melanoma in situ.ConclusionPreviously described dermoscopic features for mucosal melanoma may not have high sensitivity for early melanomas. Additional studies are needed to define the dermoscopic characteristics of mucosal melanomas that aid in early detection. Health care providers should have a low threshold for biopsy of mucosal lesions that show any clinical or dermoscopic features of melanoma, especially in older women.

show abstract

Vulvar nevi, melanosis, and melanoma: An epidemiologic, clinical, and histopathologic review

Cited by 80 publications

References 59 publications

Vulvar melanoma: relevant aspects in therapeutic management

Vulvar melanoma: relevant aspects in therapeutic management

In vivo confocal microscopic substrate of grey colour in melanosis

Early diagnosis of genital mucosal melanoma: how good are our dermoscopic criteria?

Contact Info

Product

Resources

About