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Malignant Melanoma of the Vulva

  • Doina IvanEmail author
  • Victor G. Prieto
Chapter

Abstract

Despite its relatively low incidence, vulvar melanoma carries a poor prognosis, with a high recurrence rate and metastatic potential since it is usually diagnosed at later stage. Vulvar melanoma affects usually older women, occurs mostly in the mucosal aspect of vulva, especially on labia minora and may be multifocal. According to current AJCC staging and classification, the most significant histological prognostic factors are tumor thickness, presence of mitotic figures within the invasive component and presence or absence of ulceration. The differential diagnosis of melanoma has to be made not only with other types of vulvar melanocytic lesions but also with other pigmented non-melanocytic vulvar lesions that clinically may mimic melanoma. The most challenging differential diagnosis is with melanocytic nevi with dysplastic features and nevi occurring in association with lichen sclerosus.

The treatment of choice is conservative surgical excision and sentinel lymph node excision may be also offered. Younger age, localized disease and negative lymph nodes represent independent prognostic factors for improved survival of vulvar melanoma.

Mutations and/or increased copy numbers of the gene encoding the receptor tyrosine kinase KIT have been described in up to 40 % of vulvar melanomas and currently targeted therapies with tyrosine kinase inhibitors may be used.

Keywords

Melanoma Multifocal Differential diagnosis KIT Targeted therapy 

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Departments of Pathology and DermatologyUniversity of Texas MD Anderson Cancer CenterHoustonUSA

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