11/36. Malignant melanoma associated with lichen sclerosus in the vulva of a 10-year-old.Malignant melanoma of the vulva in childhood is a rare neoplasm. Lichen sclerosus of the vulva in childhood is also a rare disease. The association of these two rare lesions in the vulva of young girls is extremely rare. We present a 10-year-old white girl with malignant melanoma associated with lichen sclerosus of the vulva. She had dark pigmentation of both the labia minora and posterior fourchette. The inner labia majora and fourchette showed whitish, glistening areas of skin. Histologic examination found mostly an in situ lentiginous/mucosal melanoma with focal invasion to a depth of 0.44 mm in the left upper labium majus. All specimens showed evidence of lichen sclerosus. Partial vulvectomy was performed, and no metastases were detected at the time of treatment. The patient has been disease free for the 12 months after treatment. It is critical for physicians to realize that melanoma can occur in children, and although rare, can occur in the vulva. We feel that lichen sclerosus in this instance may represent a pattern of host immune response to melanoma.- - - - - - - - - - ranking = 1keywords = melanoma, malignant melanoma (Clic here for more details about this article) |
12/36. Recurrent primary vulvovaginal malignant melanoma arising in melanoma in situ--the natural history of lesions followed for 23 years.Multifocal melanoma and melanoma in situ of the vulva and vagina are uncommon lesions, and our understanding of their natural history is limited. Vulvovaginal melanoma appears to be biologically different from cutaneous melanoma and has more in common with mucosal melanoma. A 60-year-old woman presented in 1977 with a pigmented vulvar lesion. Histologic examination revealed melanoma in situ associated with focal invasive melanoma. She re-presented with recurrent primary melanomas arising in melanoma in situ in 1990 and 1998 and died of widespread metastatic melanoma in 2000. melanoma in situ of the vulva and vagina is rare and appears to have a relatively slow but definite progression to invasive melanoma. All suspicious pigmented lesions in this region should be biopsied, and if multifocal in situ melanoma is identified, vulvo(vagin)ectomy should be considered.- - - - - - - - - - ranking = 2.3255937321957keywords = melanoma, malignant melanoma (Clic here for more details about this article) |
13/36. Reconstruction of the vulvar labia minora with a wedge resection.The variability in clinical appearance of vulvar tumors suggests that biopsy confirmation should be obtained for all lesions for which there is the least doubt in the diagnosis. Pigmented vulvar lesions are present in 10% to 12% of white women and the labia minora are the most common site for vulvar melanomas and atypical melanocytic nevi. Therefore, to perform a correct reconstruction, the surgeon must absolutely have a good understanding of the anatomy of the labia minora, as well as of the surgical options available, one of which is the wedge resection in the vulvar region. A classical clinical case will be used here to highlight the usefulness of wedge resection, a simple surgical technique that is applicable to the labia minora of the vulva in addition to its standard anatomic sites (auricle, lip, and eyelid).- - - - - - - - - - ranking = 0.10465039173777keywords = melanoma (Clic here for more details about this article) |
14/36. Pigmented seborrheic keratoses of the vulva clinically mimicking a malignant melanoma: a clinical, dermoscopic-pathologic case study.The diagnosis of seborrheic keratosis is, in general, a clinical one, but in some cases, the differential diagnosis between pigmented seborrheic keratosis and malignant melanoma is difficult. dermoscopy may improve the early diagnosis of vulvar melanoma and thus play a role in the preoperative classification of pigmented lesions at this particular site. We report the first case of a pigmented seborrheic keratosis of the vulva clinically mimicking a malignant melanoma, whose dermoscopic features have been investigated together with their pathologic correlates. Dermoscopically our case shows the absence of comedo-like openings and the presence of the pseudo-network. dermoscopy is therefore a useful method for the differential diagnosis of pigmented lesions even in the vulva.- - - - - - - - - - ranking = 1.0814315883248keywords = melanoma, malignant melanoma (Clic here for more details about this article) |
15/36. Basal cell carcinoma of the vulva.Basal cell carcinoma (BCC), the most common human malignancy, accounting for 75% of all non-melanoma skin cancer, is uncommon on unexposed skin such as the perianal and genital regions. We describe a woman with BCC of the vulva treated with local resection. All margins of excision were free of disease. The patient recovered without complication and there have been no recurrences after 2 years of follow-up. Approximately 200 cases of BCC on perianal and genital skin have been reported in the literature. Although the aetiology of vulvar BCC is not known, early diagnosis is important. Because BCC in these sites sometimes seems innocuous, biopsy of all suspect lesions is advisable.- - - - - - - - - - ranking = 0.10465039173777keywords = melanoma (Clic here for more details about this article) |
16/36. Synchronous cervical and vulvar malign melanomas: metastasis or multifocality of the disease? A case report and review of the literature.Vulvar melanoma is rare and has a worse prognosis and higher recurrence rate than cutaneous melanoma. Multifocality is also more common in vulvar melanomas. A case having synchronous cervix and vulvar malign melanoma is presented and discussed in the light of the literature whether it is a metastasis of vulvar malign melanoma to cervix or multifocal originated disease. In conclusion, it is important to evaluate the whole genital system in vulvar melanomas as it is in squamous cancers.- - - - - - - - - - ranking = 1.0465039173777keywords = melanoma (Clic here for more details about this article) |
17/36. A patient with multiple, malignant melanomas of the lower genital tract.Malignant melanomas of the female genital tract are uncommon lesions. A patient with multiple cutaneous, vulvar melanomas and a subsequent malignant melanoma of the cervix is described.- - - - - - - - - - ranking = 1.0232851139647keywords = melanoma, malignant melanoma (Clic here for more details about this article) |
18/36. Vulvovaginal melanoma: report of seven cases and literature review.Five cases of primary vaginal melanoma were treated at UCLA Medical Center between 1976 and 1986. Two additional cases of melanoma arising at the junction of the vulva and vagina are presented. One of seven (13%) patients is alive, with a median time to recurrence of 7 months, and median survival of 31 months. Four of five vaginal melanomas were located in the distal vagina, and all were advanced at diagnosis (greater than 3 mm depth). Mean size was 3 cm. Initial therapy was local excision in four patients and radical surgery in three. All patients had suboptimal surgical margins: two vaginal primaries had positive margins after local excision, both recurred vaginally within 5 months. Two patients had margins less than 1 mm, one died of distant metastases, the other is alive with disease 30 months after radical distal vaginectomy and hemivulvectomy with post-op pelvic radiotherapy. Three patients had melanoma in situ at the surgical margins, and each had pelvic recurrences between 6 and 26 months. Five of seven cases developed local recurrence as the initial site of treatment failure. All five vaginal cases ultimately developed distant disease, but only two patients had distant disease without local-regional recurrence. Chemotherapy and immunotherapy enabled disease stabilization in three patients. The vulvovaginal junction at the introitus is a high risk site for vaginal and vulvar melanoma. Intraoperative management requires assessment of lateral and deep spread of invasive and in situ melanoma.- - - - - - - - - - ranking = 1.0465039173777keywords = melanoma (Clic here for more details about this article) |
19/36. Proliferating giant pigmented nevus: a report of an unusual tumor occurring in association with a congenital giant pigmented nevus.A 32-year-old Japanese woman with a giant pigmented congenital nevus of the torso presented with a massive pigmented tumor mass of the vulva which grew over an 8-year period. Histologically, the tumor was composed of benign appearing nevus-like cells with focal areas of extensive fibrous response. The tumor cells were positive for S-100 protein and with an antihuman melanoma antibody (MoAb 225, 28S) stain. Electron microscopy confirmed the nevomelanocytic nature of the tumor cells and demonstrated peculiar cytoplasmic crystalline tubular structures similar to those seen in cells infected with herpes virus type II. We propose the term "proliferating giant pigmented nevus" for this previous undescribed tumor.- - - - - - - - - - ranking = 0.10465039173777keywords = melanoma (Clic here for more details about this article) |
20/36. Paget's disease, melanocytic neoplasia and hidradenoma papilliferum of the vulva.We present a case of invasive melanoma of the vulva with contiguous changes including melanocytic atypia showing, in part, the features of melanocytic dysplasia and, in part, an in situ malignant component and extramammary Paget's disease. A benign hidradenoma papilliferum was also present. We can find no other reported cases of this combination of lesions. The possible histogenesis is discussed and an origin from a common local stem cell is suggested.- - - - - - - - - - ranking = 0.10465039173777keywords = melanoma (Clic here for more details about this article) |
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