vulvar melanoma

Vulvar Melanoma: A Rare but Serious Type of Cancer

Vulvar melanoma is a rare and aggressive type of cancer that develops in the skin of the vulva, which is the outer female genitalia structures. It is a serious condition that requires prompt medical attention.

Symptoms and Signs

The symptoms and signs of vulvar melanoma can vary from person to person, but common ones include:

• A lump or growth on the vulva
• Itching, burning, and soreness or pain in the vulva
• Discoloration (skin that is lighter or darker than the skin around it)
• A noticeable lump or bump with a raw surface that feels rough
• Pain on the outside of the vagina

Types and Locations

Vulvar melanoma can develop on any area of the vulva, including:

• Clitoris
• Labia majora (the outer labia)
• Labia minora (the inner labia)
• The outside skin of the vulva

The most common site for vulvar melanoma is the labia majora.

Risk and Prevalence

Vulvar melanoma is a rare type of cancer, accounting for only 1-2% of all melanomas in women. It is estimated that one in 41 (2.4%) women will develop a malignant melanoma at some point during their life.

Treatment and Prognosis

The primary treatment for vulvar melanoma is surgery, specifically wide local excision with 1 cm margins. Early detection and treatment are crucial to improve the chances of survival.

References:

• [3] Vulvar carcinoma is a rare gynecological condition, accounting for 2-10% of all primary vulvar malignancies.
• [5] Vulvar melanoma is a rare type of melanoma that affects the vulva, which is the outer female genitalia structures.
• [9] Vulvar cancer signs and symptoms include itching, burning and soreness or pain in the vulva, and a lump, sore, swelling or wart-like growth on the vulva.
• [13] Vulvar melanoma usually grows near the clitoris or labia.

Common Signs and Symptoms of Vulvar Melanoma

Vulvar melanoma, a rare form of skin cancer that affects the vulva, can exhibit various signs and symptoms. While these may be similar to those of other vulvar cancers, it's essential to recognize them for early detection and treatment.

• Color changes: The most common symptom is a change in skin color on the vulva, which can appear darker or lighter than usual [1][2].
• Itching and burning: Many women experience itching, burning, or soreness on the vulva, which may be accompanied by pain [3][4].
• Lumps or bumps: A lump, wart-like growth, or open sore on the vulva can also be a symptom of vulvar melanoma [5][6].
• Bleeding or discharge: Some women may experience bleeding or discharge from the vulva, which can be a sign of cancer [7][8].

Other Possible Symptoms

In some cases, vulvar melanoma may not cause any noticeable symptoms. However, when they do occur, they are often nonspecific and can include:

• Moles: Changes in a mole on the vulva can be an early sign of vulvar melanoma [9].
• Skin thickening or flakiness: The skin around the vulva may become thicker or develop flakes, which can indicate cancer [10].

Early Detection is Key

Recognizing these signs and symptoms early on is crucial for effective treatment and management of vulvar melanoma. If you experience any unusual changes in your vulva, it's essential to consult a healthcare professional for proper evaluation and care.

References:

[1] Vulvar melanoma (Context #1) [2] Symptoms (Context #4) [3] Signs and symptoms of vulvar cancer may include: Itching, burning, or bleeding on the vulva that does not go away. (Context #5) [4] Symptoms of vulval melanoma · changes in the colour of the vulva · itching · bleeding · a lump · an open sore visible on the skin ... (Context #7) [5] Vulvar cancer signs and symptoms​​ Symptoms of vulvar cancer may include: itching, burning and soreness or pain in the vulva. a lump, sore, ... (Context #8) [6] Symptoms of vulvar cancer include severe itching, burning and pain on the vulva. What is vulvar cancer? Anatomy of the female pelvic area. Vulvar cancer occurs ... (Context #9) [7] In general, signs of vulvar cancer can include moles, lumps, or bumps on the vulva, flakiness or thickening of the skin in that area, or sores that don't heal. Itching and pain may also occur. ... Visual signs and symptoms of vulvar cancer vary based on the type of cancer and can include: Moles on the vulva; Lumps or bumps (flesh-colored, white ... (Context #10) [8] Vulvar melanoma is a rare form of melanoma that appears on the structures of the vulva. It may not cause signs or symptoms. When it does, they are nonspecific and can include itchiness, bleeding ... (Context #12)

Diagnostic Tests for Vulvar Melanoma

Vulvar melanoma, a rare and aggressive form of cancer, requires prompt and accurate diagnosis to ensure effective treatment. The diagnostic tests used to diagnose vulvar melanoma are crucial in determining the extent of cancer spread and planning the best course of treatment.

Imaging Tests

Imaging tests play a vital role in diagnosing vulvar melanoma. These tests can help identify if the cancer has spread from the vulva to other tissues. The following imaging tests may be used:

• X-rays: To check for any abnormalities or tumors in the vulva and surrounding areas.
• Computed Tomography (CT) scans: To create detailed images of the vulva, vagina, and surrounding organs.
• Magnetic Resonance Imaging (MRI): To provide high-resolution images of the vulva, vagina, and surrounding tissues.
• Positron Emission Tomography (PET) scans: To detect any cancer cells that may have spread to other parts of the body.

Biopsy

A biopsy is the only definitive way to diagnose vulvar melanoma. During a biopsy, a small tissue sample is removed from the affected area and examined under a microscope for cancer cells. A colposcope may be used to magnify the area and make it easier to remove the tissue.

• Punch biopsy: The most common type of biopsy used to diagnose vulvar melanoma.
• Surgical biopsy: May be done to completely remove a small lump or abnormal growth.

Other Diagnostic Tests

In addition to imaging tests and biopsies, other diagnostic tests may be used to evaluate vulvar melanoma. These include:

• Blood tests: To check for any abnormalities in blood chemistry that may indicate cancer.
• Genetic testing: May be done to identify genetic mutations associated with vulvar melanoma.

References

• [8] by J Zhao · 2024 — Conclusions: At present, the main diagnostic methods in cases of vulvar melanoma include macroscopic examination, dermoscopy, microscopy, ...
• [9] by M Omari · 2022 · Cited by 1 — The stating Cerebral, abdomino-pelvic and thoracic computed tomography scan, lumbo-pelvic MRI. PET scan can be realized in some cases especially looking for ...
• [13] Imaging tests: X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) and positron emission tomography (PET) scans can show if the cancer has spread from your vulva to other tissues.
• [12] A biopsy is the only way to definitively diagnose vulval cancer. During a biopsy, a small tissue sample is removed and examined under a microscope for cancer cells.

Treatment Options for Vulvar Melanoma

Vulvar melanoma, a rare and aggressive type of cancer, can be treated with various drug therapies. According to recent studies [5][9], immune checkpoint inhibitors have been shown to be effective in treating vulvar melanoma.

• Immunotherapy: This treatment option helps the body's immune system recognize and attack cancer cells. Recent evidences have shown that immune checkpoint inhibitors are effective in the treatment of vulvar melanoma [5][9].
• Targeted Therapy: Targeted drugs, such as those mentioned in [13], may also be used to treat vulvar melanoma.

Chemotherapy

While chemotherapy is not a primary treatment for vulvar cancer, it may be used in some cases. According to [7] and [10], chemotherapy drugs like cisplatin with or without fluorouracil (5-FU) may be used to treat vulvar cancer.

• Cisplatin: This chemotherapy drug is commonly prescribed for vulvar cancer treatment [8].
• Fluorouracil (5-FU): This chemotherapy drug may also be used in combination with cisplatin to treat vulvar cancer [7][10].

Other Treatment Options

In addition to these drug therapies, other treatment options like surgery and radiation therapy may also be considered for vulvar melanoma.

Differential Diagnosis of Vulvar Melanoma

Vulvar melanoma, a rare and aggressive form of cancer, can be challenging to diagnose due to its similarity in appearance to other skin conditions. The differential diagnosis for vulvar melanoma includes several diseases that can mimic its symptoms.

• Pigmented lesions: Mucosal melanosis, post-inflammatory hyperpigmentation, seborrheic keratosis, and pigmented basal cell carcinoma are some of the pigmented lesions that can be mistaken for vulvar melanoma [11].
• Non-melanocytic lesions: Vascular tumors, vulvar intraepithelial neoplasia, and lichen sclerosus are examples of non-melanocytic lesions that can be confused with vulvar melanoma [11].
• Other conditions: Atopic dermatitis, psoriasis, lichen planus, contact dermatitis, candidiasis, pemphigus, and cutaneous squamous cell carcinoma (SCC) are some of the other conditions that can mimic the symptoms of vulvar cancer [10].

Key Points to Consider

• Dermoscopy: Dermoscopy should be used for the differential diagnosis of pigmented lesions, including those that may resemble vulvar melanoma [15].
• Variation in clinical features: Vulvar squamous cell carcinomas (SCC) and other conditions can have similar clinical features, making differential diagnosis challenging [13].

References

[10] The differential diagnosis for vulvar cancer is broad due to the sometimes nonspecific nature of this disease. Several diseases that can mimic vulvar cancer include cutaneous SCC, cutaneous BCC, cutaneous melanoma, atopic dermatitis, psoriasis, lichen sclerosus, lichen planus, lichen chronicus simplex, contact dermatitis, candidiasis, pemphigus ...

[11] The clinical differential diagnosis of vulvar melanoma includes pigmented and non-melanocytic lesions. The pigmented lesions include mucosal melanosis and post-inflammatory hyperpigmentation. The non-melanocytic lesions can be vascular tumors, seborrheic keratosis, pigmented basal cell carcinoma, vulvar intraepithelial neoplasia, and ...

[13] Vulvar melanoma accounts for 6% to 10% of vulvar malignancies and only about 3% of all melanomas.26–28 An analysis of the National Cancer Database showed that melanoma in situ is less frequent ... Differential diagnosis. Due to the variation in the clinical features of vulvar SILs, these lesions can mimic different diseases: lichen simplex ...

[15] Vulvar cancer is rare, comprising only 5% of all gynecologic malignancies. ... Dermoscopy should be used for the differential diagnosis of pigmented lesions. Not only pigmented lesions but also nonpigmented lesions should be examined carefully because there is a unique and rare variant of melanoma which is called amelanotic melanoma ...