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2022-RA-584-ESGO Vulvar melanoma
  1. Fadoua Bouguerra,
  2. Tbessi Sabrine,
  3. Najla Attia,
  4. Rihab Melliti,
  5. Nadia Bouzid,
  6. Semia Kanoun Belajouza and
  7. Sameh Tebra
  1. Farhat Hached Hospital, Sousse, Tunisia


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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