VULVAR MELANOMA – THERAPEUTIC CONSIDERATIONS
Keywords:
vulvar melanoma, mucosal melanoma, Breslow index, adjuvant therapies, Interferon alfa-2b
Abstract
Melanoma can develop both on the skin and in the mucosa at different levels: respiratory, gastrointestinal or genital, due to the melanocyte content of these tissues. In most cases, the prognosis of melanoma at the mucosal level has a much worse prognosis compared to that for melanoma at the tegument level. Symptoms described by patients with vulvar melanoma include bleeding, itching, vaginal discharge, dyspareunia or a palpable / visible tumor formation. We present the case of a 56-year-old, presented to our service with macula about 3.5 cm in diameter, dark brown color, and irregular edges, located at the level of the upper pole of the vulva.
References
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[31] BK Ragnarsson-Olding, BR Nilsson, LR Kanter-Lewensohn, et al. Malignant melanoma of the vulva in a nationwide, 25-year study of 219 Swedish females: predictors of survival. Cancer 1999; 86:1285.
[32] TJ Miner, R Delgado, J Zeisler, et al. Primary vaginal melanoma: a critical analysis of therapy. Ann Surg Oncol 2004; 11:34.
[33] FS Suwandinata, RM Bohle, CA Omwandho, et al. Management of vulvar melanoma and review of the literature. Eur J Gynaecol Oncol 2007; 28:220.
[34] MG Bradgate, TP Rollason, CC McConkey, J Powell. Malignant melanoma of the vulva: a clinicopathological study of 50 women. Br J Obstet Gynaecol 1990; 97:124.
[35] EL Trimble, JL Lewis Jr, LL Williams, et al. Management of vulvar melanoma. Gynecol Oncol 1992; 45:254.
[36] JA de Hullu, H Hollema, HJ Hoekstra, et al. Vulvar melanoma: is there a role for sentinel lymph node biopsy? Cancer 2002; 94:486.
[37] KK Dhar, N DAS, DA Brinkman, et al. Utility of sentinel node biopsy in vulvar and vaginal melanoma: report of two cases and review of the literature. Int J Gynecol Cancer 2007; 17:720.
[38] F Sandru, A Popa, & M. C. Dumitrascu. Dermoscopic view of vertical growth phase nodular malignant melanoma. Medical Image Database, (2019) 2(2), 35-36. https://doi.org/10.33695/mid.v2i2.56.
[39] EL Trimble, JL Lewis Jr, LL Williams, et al. Management of vulvar melanoma. Gynecol Oncol 1992; 45:254.
[40] BA Jaramillo, P Ganjei, HE Averette, et al. Malignant melanoma of the vulva. Obstet Gynecol 1985; 66:398.
[41] B Lian, L Si, C Cui, et al. Phase II randomized trial comparing high-dose IFN-α2b with temozolomide plus cisplatin as systemic adjuvant therapy for resected mucosal melanoma. Clin Cancer Res 2013; 19:4488.
[42] RD Carvajal, CR Antonescu, JD Wolchok, et al. KIT as a therapeutic target in metastatic melanoma. JAMA 2011; 305:2327.
[43] JA Curtin, K Busam, D Pinkel, BC Bastian. Somatic activation of KIT in distinct subtypes of melanoma. J Clin Oncol 2006; 24:4340.
[44] HL Bartell, AY Bedikian, NE Papadopoulos, et al. Biochemotherapy in patients with advanced head and neck mucosal melanoma. Head Neck 2008; 30:1592.
[45] MA Hyde, ML Hadley, P Tristani-Firouzi, et al. A randomized trial of the off-label use of imiquimod, 5%, cream with vs without tazarotene, 0.1%, gel for the treatment of lentigo maligna, followed by conservative staged excisions. Arch Dermatol 2012; 148:592.
[46] AB Bong, B Bonnekoh, I Franke, et al. Imiquimod, a topical immune response modifier, in the treatment of cutaneous metastases of malignant melanoma. Dermatology 2002; 205:135.
[47] IH Wolf, J Smolle, B Binder, et al. Topical imiquimod in the treatment of metastatic melanoma to skin. Arch Dermatol 2003; 139:273.
[48] MF Naylor, N Crowson, R Kuwahara, et al. Treatment of lentigo maligna with topical imiquimod. Br J Dermatol 2003; 149 Suppl 66:66.
[49] AM Powell, AM Robson, R Russell-Jones, RJ Barlow. Imiquimod and lentigo maligna: a search for prognostic features in a clinicopathological study with long-term follow-up. Br J Dermatol 2009; 160:994.
[50] H Gökaslan, A Sişmanoğlu, T Pekin, et al. Primary malignant melanoma of the vagina: a case report and review of the current treatment options. Eur J Obstet Gynecol Reprod Biol 2005; 121:243.
[2] KM Moxley, AN Fader, PG Rose, et al. Malignant melanoma of the vulva: an extension of cutaneous melanoma? Gynecol Oncol 2011; 122:612.
[3] EE Katz, K Suzue, MA Wille, et al. Primary malignant melanoma of the urethra. Urology 2005; 65:389.
[4] T Kojima, T Tanaka, N Yoshimi, H Mori. Primary malignant melanoma of the urinary bladder. Arch Pathol Lab Med 1992; 116:1213.
[5] WE Khalbuss, M Hossain, A Elhosseiny. Primary malignant melanoma of the urinary bladder diagnosed by urine cytology: a case report. Acta Cytol 2001; 45:631.
[6] KC Clark, WR Butz, MR Hapke. Primary malignant melanoma of the uterine cervix: case report with world literature review. Int J Gynecol Pathol 1999; 18:265.
[7] G Cantuaria, R Angioli, J Nahmias, et al. Primary malignant melanoma of the uterine cervix: case report and review of the literature. Gynecol Oncol 1999; 75:170.
[8] WT Creasman, JL Phillips, HR Menck. A survey of hospital management practices for vulvar melanoma. J Am Coll Surg 1999; 188:670.
[9] A Stang, B Streller, B Eisinger, KH Jöckel. Population-based incidence rates of malignant melanoma of the vulva in Germany. Gynecol Oncol 2005; 96:216.
[10] JY Hou, C Baptiste, RB Hombalegowda, et al. Vulvar and vaginal melanoma: A unique subclass of mucosal melanoma based on a comprehensive molecular analysis of 51 cases compared with 2253 cases of nongynecologic melanoma. Cancer 2017; 123:1333.
[11] BK Ragnarsson-Olding, LR Kanter-Lewensohn, B Lagerlöf, et al. Malignant melanoma of the vulva in a nationwide, 25-year study of 219 Swedish females: clinical observations and histopathologic features. Cancer 1999; 86:1273.
[12] ME Wechter, SB Gruber, HK Haefner, et al. Vulvar melanoma: a report of 20 cases and review of the literature. J Am Acad Dermatol 2004; 50:554.
[13] B Piura, M Egan, A Lopes, JM Monaghan. Malignant melanoma of the vulva: a clinicopathologic study of 18 cases. J Surg Oncol 1992; 50:234.
[14] B Piura, A Rabinovich, R Dgani. Malignant melanoma of the vulva: report of six cases and review of the literature. Eur J Gynaecol Oncol 1999; 20:182.
[15] CF Verschraegen, M Benjapibal, W Supakarapongkul, et al. Vulvar melanoma at the M. D. Anderson Cancer Center: 25 years later. Int J Gynecol Cancer 2001; 11:359.
[16] B Piura, A Rabinovich, I Yanai-Inbar. Primary malignant melanoma of the vagina: case report and review of literature. Eur J Gynaecol Oncol 2002; 23:195.
[17] VE Sugiyama, JK Chan, JY Shin, et al. Vulvar melanoma: a multivariable analysis of 644 patients. Obstet Gynecol 2007; 110:296.
[18] G Borazjani, KA Prem, T Okagaki, et al. Primary malignant melanoma of the vagina: a clinicopathological analysis of 10 cases. Gynecol Oncol 1990; 37:264.
[19] CM Balch, AC Buzaid, SJ Soong, et al. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J Clin Oncol 2001; 19:3635.
[20] WH Clark Jr, L From, EA Bernardino, MC Mihm. The histogenesis and biologic behavior of primary human malignant melanomas of the skin. Cancer Res 1969; 29:705.
[21] A Breslow. Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma. Ann Surg 1970; 172:902.
[22] AF Chung, JM Woodruff, JL Lewis Jr. Malignant melanoma of the vulva: A report of 44 cases. Obstet Gynecol 1975; 45:638.
[23] GL Phillips, BN Bundy, T Okagaki, et al. Malignant melanoma of the vulva treated by radical hemivulvectomy. A prospective study of the Gynecologic Oncology Group. Cancer 1994; 73:2626.
[24] KM Moxley, AN Fader, PG Rose, et al. Malignant melanoma of the vulva: an extension of cutaneous melanoma? Gynecol Oncol 2011; 122:612.
[25] S Seifried, LE Haydu, MJ Quinn, et al. Melanoma of the vulva and vagina: principles of staging and their relevance to management based on a clinicopathologic analysis of 85 cases. Ann Surg Oncol 2015; 22:1959.
[26] WP Irvin Jr, RL Legallo, MH Stoler, et al. Vulvar melanoma: a retrospective analysis and literature review. Gynecol Oncol 2001; 83:457.
[27] EL Trimble. Melanomas of the vulva and vagina. Oncology (Williston Park) 1996; 10:1017.
[28] KM Moxley, AN Fader, PG Rose, et al. Malignant melanoma of the vulva: an extension of cutaneous melanoma? Gynecol Oncol 2011; 122:612.
[29] DJ Buchanan, J Schlaerth, T Kurosaki. Primary vaginal melanoma: thirteen-year disease-free survival after wide local excision and review of recent literature. Am J Obstet Gynecol 1998; 178:1177.
[30] P DeMatos, D Tyler, HF Seigler. Mucosal melanoma of the female genitalia: a clinicopathologic study of forty-three cases at Duke University Medical Center. Surgery 1998; 124:38.
[31] BK Ragnarsson-Olding, BR Nilsson, LR Kanter-Lewensohn, et al. Malignant melanoma of the vulva in a nationwide, 25-year study of 219 Swedish females: predictors of survival. Cancer 1999; 86:1285.
[32] TJ Miner, R Delgado, J Zeisler, et al. Primary vaginal melanoma: a critical analysis of therapy. Ann Surg Oncol 2004; 11:34.
[33] FS Suwandinata, RM Bohle, CA Omwandho, et al. Management of vulvar melanoma and review of the literature. Eur J Gynaecol Oncol 2007; 28:220.
[34] MG Bradgate, TP Rollason, CC McConkey, J Powell. Malignant melanoma of the vulva: a clinicopathological study of 50 women. Br J Obstet Gynaecol 1990; 97:124.
[35] EL Trimble, JL Lewis Jr, LL Williams, et al. Management of vulvar melanoma. Gynecol Oncol 1992; 45:254.
[36] JA de Hullu, H Hollema, HJ Hoekstra, et al. Vulvar melanoma: is there a role for sentinel lymph node biopsy? Cancer 2002; 94:486.
[37] KK Dhar, N DAS, DA Brinkman, et al. Utility of sentinel node biopsy in vulvar and vaginal melanoma: report of two cases and review of the literature. Int J Gynecol Cancer 2007; 17:720.
[38] F Sandru, A Popa, & M. C. Dumitrascu. Dermoscopic view of vertical growth phase nodular malignant melanoma. Medical Image Database, (2019) 2(2), 35-36. https://doi.org/10.33695/mid.v2i2.56.
[39] EL Trimble, JL Lewis Jr, LL Williams, et al. Management of vulvar melanoma. Gynecol Oncol 1992; 45:254.
[40] BA Jaramillo, P Ganjei, HE Averette, et al. Malignant melanoma of the vulva. Obstet Gynecol 1985; 66:398.
[41] B Lian, L Si, C Cui, et al. Phase II randomized trial comparing high-dose IFN-α2b with temozolomide plus cisplatin as systemic adjuvant therapy for resected mucosal melanoma. Clin Cancer Res 2013; 19:4488.
[42] RD Carvajal, CR Antonescu, JD Wolchok, et al. KIT as a therapeutic target in metastatic melanoma. JAMA 2011; 305:2327.
[43] JA Curtin, K Busam, D Pinkel, BC Bastian. Somatic activation of KIT in distinct subtypes of melanoma. J Clin Oncol 2006; 24:4340.
[44] HL Bartell, AY Bedikian, NE Papadopoulos, et al. Biochemotherapy in patients with advanced head and neck mucosal melanoma. Head Neck 2008; 30:1592.
[45] MA Hyde, ML Hadley, P Tristani-Firouzi, et al. A randomized trial of the off-label use of imiquimod, 5%, cream with vs without tazarotene, 0.1%, gel for the treatment of lentigo maligna, followed by conservative staged excisions. Arch Dermatol 2012; 148:592.
[46] AB Bong, B Bonnekoh, I Franke, et al. Imiquimod, a topical immune response modifier, in the treatment of cutaneous metastases of malignant melanoma. Dermatology 2002; 205:135.
[47] IH Wolf, J Smolle, B Binder, et al. Topical imiquimod in the treatment of metastatic melanoma to skin. Arch Dermatol 2003; 139:273.
[48] MF Naylor, N Crowson, R Kuwahara, et al. Treatment of lentigo maligna with topical imiquimod. Br J Dermatol 2003; 149 Suppl 66:66.
[49] AM Powell, AM Robson, R Russell-Jones, RJ Barlow. Imiquimod and lentigo maligna: a search for prognostic features in a clinicopathological study with long-term follow-up. Br J Dermatol 2009; 160:994.
[50] H Gökaslan, A Sişmanoğlu, T Pekin, et al. Primary malignant melanoma of the vagina: a case report and review of the current treatment options. Eur J Obstet Gynecol Reprod Biol 2005; 121:243.
Published
2020-01-25
How to Cite
Șandru, F., Dumitrașcu, M., Teodorescu, C., Miulescu, R., Petca, A., & Popa, A. (2020). VULVAR MELANOMA – THERAPEUTIC CONSIDERATIONS. Romanian Journal of Clinical Research, 3(1), 8-13. https://doi.org/10.33695/rjcr.v3i1.45
Section
Articles
