Introduction/Background Optimal treatments for vulvar melanomas (VM) have not been identified. VM has a poor prognosis due to late diagnosis and early dissemination. Only a limited amount of literature exists on this condition. This study elucidates the effect of current treatment.

Methodology We report all patients diagnosed with malignant melanoma in the vulva at Salah Azaiez Institute, between June 2011 and May 2022, from retrospective chart review and histologic analysis.

Results A total of 6 patients were included. The mean age at the time of diagnosis was 41. 5 years. The majority of the melanomas were nodular. Superficially spreading melanomas only on the vulva were found in four patients; however, extension on the vagina was found in two cases. Five patients underwent radical surgery: total vulvectomy with bilateral inguinofemoral lymphadenectomy. One patient underwent wide local excision and sentinel lymph node investigation. This patient had local recurrence after 3 months; she had a radical vulvectomy and lymph node dissection. Histological findings showed free margins in all the patients. The median disease-free survival was 7 months and the median overall survival time was almost 14 months.

Conclusion Vulvar melanomas differ from nongenital cutaneous melanoma in epidemiologic characteristics and treatment paradigms. The prognosis is generally poor, with a high tendency to loco-regional and distant metastasis; thus, early diagnosis and staging are very important.