Malignant melanoma of the vulva: clinicopathological features

Abstract

From the files of the Scottish Melanoma Group, we have identified 41 cases of vulval malignant melanoma, which represents 1.7% of all the melanomas occurring in women in Scotland, during the period 1979–1989. Thirty-seven were aged 50 years or older with the mean age being 70 years. The average Breslow depth of the lesions was 6.0 mm, with 29 being greater than 3.0 mm in depth. Nineteen cases were polypoidal and 37 were ulcerated. Six patients had radical vulvectomy with lymph node dissection, three had biopsy and palliative treatment, and the majority of the remaining patients had local excision only, with surgical margins of less than 2 cm. The 5-year survival rate (available for 23 patients) is 21.7%, compared to 72% for cutaneous melanoma in females, in general, in the same population. In this series, the survival rate is poor, as the lesions occurred in elderly women and the melanomas were thick at presentation. Surgical treatment appears to have been rather conservative in those who were dead from their disease at 5 years.