Introduction/Background Vulvar melanoma is a very rare gynecological tumor. It represents only 1% of all melanomas. It affects, in order of frequency, the vagina, the uterus and the ovaries. Less than 200 cases have been reported in the literature.
Methodology We report a clinical case of a metastatic vulvar malignant melanoma treated at the Radiotherapy oncology Department of the Farhat Hached Hospital in Sousse.
Results The case represents a 67 year old hypertensive woman who was being monitored for ACFA. We were consulted for a painful vulvar swelling evolving for 6 months. On examination, it appeared to be an ulcerating lesion on the vulva, crusty, superinfected, bleeding 7 cm GA with a fixed right inguinal adenopathy of 2 cm long axis; speculum examination finds a healthy cervix, the recto-vaginal septum is free.A biopsy of the lesion was performed, showing a spindle cell tumor proliferation, probably malignant, with a melanoma of the vulvar commissure on IHC. On thoracic-abdominal-pelvic CT scan, multiple deep cutaneous, pulmonary, splenic and left renal nodules associated with a peripheral hepatic mass and retroperitoneal adenomegaly, of secondary appearance, were observed. The patient underwent analgesic radiotherapy at a dose of 20 Gy in 5 fractions. Two weeks after treatment, the patient died.
Conclusion Vulvar melanoma is an aggressive tumour and has a poor prognosis. Although surgical treatment is the gold standard for localized forms, the therapeutic modalities are not codified for metastatic forms.
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