Managing vulvovaginal melanomas

By Beverly A. Jaramillo, MD

Although these cancers are rare, they can be even more deadly than melanomas appearing on other parts of the body— and more easily overlooked. To detect these malignancies early on, have any suspicious lesions promptly biopsied.

Even though malignant melanoma of the vulva is a relatively rare disease, its prognosis is usually poor, with survival dependent upon tumor thickness or level of infiltration. Early diagnosis is therefore imperative and key to managing these cancers. The importance of using vulvar biopsies liberally cannot be overstressed. The gynecologist also must understand the differential diagnosis of the pigmented or dark vulvar lesion, as well as some of the subtle differences between benign and malignant lesions. (Vaginal melanomas, which are extremely rare, will be discussed at the end of this article.)

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