Melanoma of the vulva: A retrospective study of 46 cases from Queensland

Objective: To review the records of cases of vulvar melanoma referred to the Queensland Centre for Gynaecological Cancer (QCGC) between 1986 and 2009 recognising the high incidence of cutaneous melanoma in Queensland. Methods: Vulvar melanoma case data from QCGC were reviewed and analysed using the computer software Statistical Package for the Social Sciences (SPSS) 11.0. Results: Of the 46 cases 22 died of their disease, nine died of other diseases, ten are still alive and five lost to follow up. The mean age at diagnosis was 65.5 years for nodular melanoma and 69 years for superficial spreading melanoma. All cases were Caucasian. Time from on-set of symptoms to diagnosis averaged 3.2 months. In all 46 cases diagnosis was confirmed histologically. Presenting symptoms included lumps, itch, stinging, bleeding and pain. The most common presenting complaint was a lump. The initial treatment was surgical without a trend to a less radical approach to management. Conclusions: Vulvar melanoma prognosis remains guarded. Increased tumor size, depth of invasion, mitotic rate, groin lymph node positivity and status of disease at the margins of surgical specimens reliably equate to long term outcome. The incidence of vulvar melanoma was not increased in Queensland.