Vulvar and vaginal melanoma. A clinicopathologic study.

Melanoma of the vulva is uncommon, and melanoma of the vagina is rare. The overall prognosis is poor and worse than for cutaneous melanomas. This appears to relate to diagnosis of genital lesions at an advanced stage. In a 28-year, retrospective analysis at Columbia Presbyterian Medical Center, there were 10 cases of primary melanoma of the lower genital tract. Seven cases of vulvar melanoma and three cases of vaginal melanoma were reviewed. All cases were in elderly women, and all were diagnosed at an advanced stage. The outcome in general was poor, regardless of therapy. This condition must be recognized earlier to afford an optimal patient outcome. Elderly women must undergo regular gynecologic care, and suspicious pigmented lesions must be biopsied.