Vulvar melanoma can strike younger women

Vulvar melanoma can strike younger women – Case Report

Nancy Walsh

PORTO, PORTUGAL — Despite its reputation as a malignancy of elderly females, vulvar melanoma also can occur in younger women, Dr. Patricia Santos reported. at the 23rd Congress of the International Society for Dermatologic Surgery.

A pigmented lesion of the vulva was noted on a routine annual examination of a 39-year-old woman, Dr. Santos said. The 3.5cm lesion occupied the lowest portion of the labia minora and was irregular and ulcerated.

It was flat and not indurated or tender, and no inguinal adenopathy was present.

Histologic evaluation determined it to be a superficial spreading melanoma of 1.5-mm thickness. There was no evidence of local spread or metastasis.

The woman underwent a partial vulvectomy with 2-cm surgical margins, and reconstruction was done using an inguinal skin flap.

“Our patient had a relatively large lesion that needed careful evaluation and surgery in order to remove the cancer and reconstruct the anatomic area,” said Dr. Santos of the Hospital de Curry Cabral, Lisbon.

“We think the pudendal thigh, or Singapore, flap was a good choice to achieve this,” she said.

The patient has had no adjuvant treatment during the 9 months since surgery, but careful follow-up will be required, Dr. Santos said.

Most cases of vulvar melanoma are seen in women older than 60 years, she noted, and diagnosis is often delayed.

The prognosis for this malignancy is worse than for other primary tumors of the female genital tract. In one series of 14 cases seen over a period of 20 years, there were six recurrences and all six patients died (Gynecol. Oncol. 83[3]:457-65, 2001).

COPYRIGHT 2003 International Medical News Group

COPYRIGHT 2003 Gale Group