Introduction/Background*Primary melanomas originating from the gynecological tract are rare and aggressive cancers. The majority of patients experience poor long-term survival. Our objective is to describe the diagnosis, treatment and survival of patients diagnosed with vulvar melanoma in a tertiary Spanish hospital during a 9-year period.
Methodology Retrospective descriptive cohort study of patients diagnosed with vulvar melanoma between 01/2011 and 12/2020 at University Hospital 12 de Octubre, Madrid, Spain.
Result(s)*A total of 7 women were included. The mean age at diagnosis was 74.7 ± 9.7 years. All women consulted for a mass located in genital tract meanly at labia minora. In all patients gynecologic examination revealed pigmented lesion from which a biopsy was taken. Histologic examination indicated the diagnose of a melanoma. The mean tumor’s size was 3.5 ± 2.1 cm with clinically negative nodes and a mean Breslow depth 11.2 ± 8.7 mm. PET-CT was solicited as presurgical imaging workup.
According to the AJCC Cancer Staging Manual, 3/7 (42.8%) of patients were diagnosed at IIC stage, 1/7 (14.3%) at IIIB stage, 2/7 (28.6%) at IIIC stage and 1/7 (14.3%) at IV stage. The treatment was surgery: 3/7 (42.8%) of patients underwent wide local excision and 4/7 (57.2%) of patients underwent hemivulvectomy. Negative margins were obtained in 4/7 (57.2%) of surgerys. Sentinel lymph node (SLN) biopsy was performed in 5/7 (71.4%) of patients and SLN confirmed nodal metastases in 4/5 (80%) of patients. Immunotherapy was the adjuvant treatment for patients with ≥ IIIB stage (4/7), one of them combined with radiotherapy.
During the follow up, 5/7 (71.4%) of patients relapsed. The mean time to relapsed was 5.5± 2.3 months. The treatment for the recurrences was 3/5 (60%) cytoreductive surgery combined with immunotherapy in two patients. One woman (20%) received a combination of radiotherapy and immunotherapy and other woman (20%) received palliative treatment. At the time of last follow up, 4/7 (57.2%) women died because of melanoma, 2/7 (28.6%) was tumor free and 1/7 (14.3%) was alive with the disease.
Conclusion*As reported in literature, primary vulvar melanomas have biologically aggressive characteristics. The treatment consists of a surgery with appropriate free surgical margins. However, early recognition is what brings the maximal benefit to survival.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.