Although relatively rare, this is the second most common type of vulvar cancer. It occurs most commonly in women around the age of menopause and in postmenopausal women.
More than 80 percent of melanomas arise from the labia minora and clitoris. Most women seek medical attention because of itching, bleeding or a lump. Superficially spreading melanomas and mucocutaneous melanomas account for approximately 60 percent and 10 percent respectively of all vulvar melanomas and are somewhat slow growing until invasion occurs. Thirty percent are nodular melanomas, which behave much more aggressively.
Standard Treatment Radical vulvectomy and bilateral groin node dissection is the standard therapy, although over the past few years there has been a trend toward more conservative surgery.
Melanomas that are less than 0.7 mm in thickness without vascular space involvement can be treated by a wide local excision with a 3/4 in. (2 cm) skin margin, without a groin dissection.
The role of a pelvic lymph node dissection has not been determined, but if the groin nodes are involved, a pelvic lymph node dissection may be performed. The prognosis and survival is determined in large part by the depth of invasion and whether there are metastases.
Five-Year Survival 40 to 80 percent depending on the stage and the depth of invasion
