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Chapter 22 - Vulvar Melanoma

Published online by Cambridge University Press:  23 October 2024

By
Ana M. Ciurea
Edited by
Laurie J. Mckenzie  and
Denise R. Nebgen
Laurie J. Mckenzie
Affiliation:
University of Texas MD Anderson Cancer Center, Houston
Denise R. Nebgen
Affiliation:
University of Texas MD Anderson Cancer Center, Houston
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Summary

Vulvar melanoma is a rare malignant tumor of the female genital tract that affects mostly women in the 5th−8th decade of life. A histopathological evaluation and immunohistochemical analysis are paramount to confirm the diagnosis. Treatment requires a multidisciplinary approach. Secondary to a high metastatic potential as well as late diagnosis due to non-specific clinical signs, the prognosis is typically poor. Close monitoring, patient education regarding self-skin examination and screening are necessary for all atypical lesions and to identify local recurrences.

Keywords

melanomavulvartumor markerstreatmentprognosissurveillance
Type
Chapter
Information
Caring for the Female Cancer Patient
Gynecologic Considerations
 , pp. 383 - 393
Publisher: Cambridge University Press
Print publication year: 2024

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References

Muzarku, E. C., Peunn, L. A., Hale, C., Pomeranz, M. K., Polsky, D. Vulvar nevi, melanosis and melanoma: An epidemiologic, clinical, and histopathologic review. J Am Acad Dermatol. 2014;71(6):1241–9.Google Scholar
Moxley, K. M., Fader, A. N., Rose, P. G., et al. Malignant melanoma of the vulva: An extension of cutaneous melanoma? Gynecol Oncol. 2011;122:612–17.CrossRefGoogle ScholarPubMed
Wolmuth, C., Wolmuth-Wieser, I. Vulvar melanoma: Molecular characteristics, diagnosis, surgical management, and medical treatment. Am J Clin Dermatol. 2021;22:639–51.Google Scholar
Weinstock, M. A. Malignant melanoma of the vulva and vagina in the United States: Patterns of incidence and population-based estimates of survival. AM J Obst Gybecol. 1994;171:1225–30.Google Scholar
Li, K. P., Ajebo, E. M., Diamond, D., Powell, M., Belcher, M. Primary vulvar melanoma in an adolescent patient. Pediatr Dermatol. 2023. doi: 10.1111/pde.15296CrossRefGoogle Scholar
La Spina, M., Meli, M. C., De Pasquale, R., et al. Vulvar melanoma associated with lichen sclerosus in a child: Case report and literature review. Pediatr Dermatol. 2016;33(3):e190–e194.CrossRefGoogle Scholar
Erickson, M. K., Pontes, D., Memon, R., Schlosser, B. J. 16835 A US population-based epidemiologic study of vulvar melanoma from the Surveillance, Epidemiology, and End Results (SEER) database. J Am Acad Dermatol. 2020;83(6):AB72CrossRefGoogle Scholar
Siegel, R. L., Miller, K. D., Jemal, A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7–30. doi: 10.3322/caac.21590. Epub 2020 Jan 8.CrossRefGoogle ScholarPubMed
Wohlmuth, C., Wohlmuth-Wieser, I., May, T., Vicus, D., Gien, L. T., Laframboise, S. Malignant melanoma of the vulva and vagina: A US population-based study of 1863 patients. Am J Clin Dermatol. 2020;21(2):285–95. doi: 10.1007/s40257-019-00487-x.CrossRefGoogle Scholar
Pleunis, N., Schuurman, M. S., Van Rossum, M. M., et al. Rare vulvar malignancies; incidence, treatment and survival in the Netherlands. Gynecol Oncol. 2016;142(3):440–5.CrossRefGoogle ScholarPubMed
Rosamilia, L. L., Schwartz, J. L., Lowe, L., et al. Vulvar melanoma in a 10-year-old girl in association with lichen sclerosus. J Am Acad Dermatol. 2006;54 (Suppl):S52–S53.CrossRefGoogle Scholar
Schaffer, J. V., Orlow, S. J. Melanocytic proliferations in the setting of vulvar lichen sclerosus: Diagnostic considerations. Pediatr Dermatol. 2005;22:276–8.CrossRefGoogle ScholarPubMed
Rohwedder, A., Slominski, A., Wolff, M., Kredentser, D., Carlson, J. A. Epidermodysplasia verruciformis and cutaneous human papillomavirus DNA, but not genital human papillomavirus DNAs, are frequently detected in vulvar and vaginal melanoma. Am J Dermatopathol. 2007;29:13–17.CrossRefGoogle Scholar
Pawelec, M., Karmowski, A., Karmowski, M. Where the sun does not shine: Is sunshine protective against melanoma of the vulva? J Photochem Photobiol B. 2010;101:179–83.Google Scholar
Curtin, J. A., Busam, K., Pinkel, D., Bastian, B. C. Somatic activation of KIT in distinct subtypes of melanoma. J Clin Oncol.2006;24:4340–6.CrossRefGoogle ScholarPubMed
Willmore-Payne, C., Holden, J. A., Tripp, S., Layfeld, L. J. Human malignant melanoma: Detection of BRAF- and c-kit-activating mutations by high-resolution amplicon melting analysis. Hum Pathol. 2005;36:486–93.CrossRefGoogle ScholarPubMed
Pleunis, N., Schuurman, M. S., Van Rossum, M. M., et al. Rare vulvar malignancies: Incidence, treatment and survival in the Netherlands. Gynecol Oncol. 2016;142:440–5.CrossRefGoogle ScholarPubMed
Hou, J. Y., Baptiste, C., Hombalegowda, R. B., 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;123:1333–44.CrossRefGoogle ScholarPubMed
Grill, C., Larue, L. NRAS, NRAS, which mutation is fairest of them all? J Invest Dermatol. 2016;136:1936–8.CrossRefGoogle Scholar
Gray-Schopfer, V., Wellbrock, C., Marais, R. Melanoma biology and new targeted therapy. Nature. 2007;445:851–7.CrossRefGoogle ScholarPubMed
Hassel, J. C., Livingstone, E., Allam, J. P., et al. Fertility preservation and management of pregnancy in melanoma patients requiring systemic therapy. ESMO Open. 2021;6(5):100248.CrossRefGoogle ScholarPubMed
Filippi, F., Serra, N., Vigano, P., et al. Fertility preservation for patients with melanoma. Melanoma Res. 2022;32(5):303–8.Google ScholarPubMed
Scott, A. R., Stoltzfus, K. C., Tchelebi, L. T., et al. Trends in cancer incidence in US adolescents and young adults, 1973–2015. JAMA Netw Open. 2020;3(12):e2027738.CrossRefGoogle Scholar
van der Meer, D. J., Karim-Kos, H. E., van der Mark, M., et al. Incidence, survival, and mortality trends of cancer diagnosed in adolescents and young adults (15-39 years): A population-based study in the Netherlands 1990-2016. Cancer (Basel). 2020;12(11):3421.CrossRefGoogle Scholar
ESHRE Guideline Group on Female Fertility Preservation, Anderson R. A., Amant F., et al. ESHRE guideline: female fertility preservation. Hum Reprod Open. 2020;2020(4):hoaa052.CrossRefGoogle Scholar
European Medicines Agency ICH guideline S9 on nonclinical evaluation for anticancer pharmaceuticals (EMA/CHMP/ICH/646107/2008, May 2010). www.ema.europa.eu/en/documents/scientific-guideline/ich-guideline-s9-non-clinical-evaluation-anticancer-pharmaceuticals-step-5_en.pdf.Google Scholar
Bonelli, M., Di Giuseppe, F., Beken, S. Impact analysis of ICH S9 on non-clinical development of anticancer drugs. Regul Toxicol Pharmacol. 2015;73(1):361–6.CrossRefGoogle ScholarPubMed
Poulet, F. M., Wolf, J. J., Herzyk, D. J., DeGeorge, J. J. An evaluation of the impact of PD-1 pathway blockade on reproductive safety of therapeutic PD-1 inhibitors. Birth Defects Res B Dev Reprod Toxicol. 2016;107(2):108–19.CrossRefGoogle ScholarPubMed
Eigentler, T. K., Hassel, J. C., Berking, C., et al. Diagnosis, monitoring and management of immune-related adverse drug reactions of anti-PD-1 antibody therapy. Cancer Treat Rev. 2016;45:7–18.CrossRefGoogle ScholarPubMed
Hassel, J. C., Heinzerling, L., Aberle, J., et al. Combined immune checkpoint blockade (anti-PD-1/anti-CTLA-4): Evaluation and management of adverse drug reactions. Cancer Treat Rev. 2017;57:36–49.CrossRefGoogle ScholarPubMed
Menzer, C., Beedgen, B., Rom, J., et al. Immunotherapy with ipilimumab plus nivolumab in a stage IV melanoma patient during pregnancy. Ur J Cancer. 2018;104:239–42.Google Scholar
Azim, H. A. Jr, Peccatori, F. A., Pavlidis, N. Treatment of the pregnant mother with cancer: A systematic review on the use of cytotoxic, endocrine, targeted agents and immunotherapy during pregnancy. Part I: Solid tumors. Cancer Treat Rev. 201;36(2):101–9.Google Scholar
Practice Committee of the American Society for Reproductive Medicine. Electronic address: . Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion. Fertil Steril. 2019;112(6):1022–33.Google Scholar
Dolmans, M. M., Taylor, H. S., Rodriguez-Wallberg, K. A., et al. Utility of gonadotropin-releasing hormone agonists for fertility preservation in women receiving chemotherapy: Pros and cons. Fertil Steril. 2020;114(4):725–38.CrossRefGoogle ScholarPubMed
Ragnarsson-Olding, B. K., Kanter-Lewensohn, L. R., Lagerlöf, B., Nilsson, B. R., Ringborg, U. K. Malignant melanoma of the vulva in a nationwide, 25-year study of 219 Swedish females: Clinical observations and histopathologic features. Cancer. 1999;86:1273–84.3.0.CO;2-P>CrossRefGoogle Scholar
Liu, W., Hill, D., Gibbs, A. F., et al. What features do patients notice that help to distinguish between benign pigmented lesions and melanomas?: The ABCD(E) rule versus the seven-point checklist. Melanoma Res. 2005;15(6):549–54.CrossRefGoogle ScholarPubMed
Vaccari, S., Barisani, A., Salvini, C., et al. Thin vulvar melanoma: A challenging diagnosis. Dermoscopic features of a case series. Clin Exp Dermatol. 2020;45(2):187–93.CrossRefGoogle ScholarPubMed
Theillac, C., Cinotti, E., Malvehy, J., et al. Evaluation of large clinically atypical vulvar pigmentation with RCM: Atypical melanosis or early melanoma? J Eur Acad Dermatol Venereol. 2019;33(1):84–92.CrossRefGoogle ScholarPubMed
Fuchs, E., Khanijow, A., Garcia, R. L., Goff, B. A. Imiquimod treatment of vulvar melanoma in situ invading the urethra. Gynecol Oncol Rep. 2021;3;38:100875.CrossRefGoogle Scholar
Omari, M., Zaimi, A., Kacem, H. H., Afqir, S. Vulvar melanoma: A diagnostic challenge for young women – a case report. Ann Med Surg (Lond). 2022;25(81):104473.Google Scholar
Iacoponi, S., Rubio, P., Garcia, E., Oehler, M. K., Diez, J . (VULCAN Study collaborative group). Prognostic factors of recurrence and survival in vulvar melanoma: Subgroup analysis of the VULvar CANcer Study. Int J Gynecol Cancer. 2016;26(7):1307–12.CrossRefGoogle ScholarPubMed

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  • Vulvar Melanoma
  • Edited by Laurie J. Mckenzie, University of Texas MD Anderson Cancer Center, Houston, Denise R. Nebgen, University of Texas MD Anderson Cancer Center, Houston
  • Book: Caring for the Female Cancer Patient
  • Online publication: 23 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781009279864.022
Available formats
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Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Vulvar Melanoma
  • Edited by Laurie J. Mckenzie, University of Texas MD Anderson Cancer Center, Houston, Denise R. Nebgen, University of Texas MD Anderson Cancer Center, Houston
  • Book: Caring for the Female Cancer Patient
  • Online publication: 23 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781009279864.022
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Vulvar Melanoma
  • Edited by Laurie J. Mckenzie, University of Texas MD Anderson Cancer Center, Houston, Denise R. Nebgen, University of Texas MD Anderson Cancer Center, Houston
  • Book: Caring for the Female Cancer Patient
  • Online publication: 23 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781009279864.022
Available formats
×