European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
Malignant melanoma ofthe vulva: report of six cases and review of the literature
Six patients with vulvar malignant melanoma are reported. They accounted for 5.2% of all females with vulvar malignancies diagnosed in the south of Israel between 1961 and 1997. Age ranged from 25 to 66 years. Presenting symptoms were pruritus, bleeding and ulcer. Lesion originated in the labia minora in four patients and the labia manora in two, and lesion size ranged from 1 to 8 cm. Five patients had nodular melanoma, and one had superficial spreading melanoma. Breslow depth ranged from 2.5 to 8 mm, Clark level was IV in four patients and III in two, and Chung level was IV in all patients. Two patients had radical vulvectomy and bilateral groin lymphadenectomy, one had wide local excision, and one refused surgery. The two patients who had radical hemi-vulvectomy and bilateral groin lymphadenectomy were given adjuvant active specific immunotherapy with allogeneic vaccine and have survived disease-free, whereas the remaining four patients died of disease. It is concluded that vulvar malignant melanoma is a rare and aggressive tumor. For patients who present with deep lesions (Breslow depth > 0.76 mm, Clark level > II, Chung level> II) the recommended treatment is wide radical local excision (or at the most, radical hemivulvectomy) and bilateral groin lymphadenectomy.