Vulvovaginal melanoma. A clinicopathologic study.
A retrospective study was done on 14 patients with vulvar and vaginal melanoma treated at the New York University Medical Center from 1972 through 1984. Pathologic evaluation included a measurement of tumor volume, tumor thickness, growth pattern and cell type. The most common morphologic appearance was a superficial spreading growth pattern with a nevoid cell type, which seemed to correlate with a favorable outcome. Nodular growth pattern with an epithelioid cell type was less common and associated with a poorer prognosis and inguinal lymph node metastases. No patient had deep pelvic node metastases. Tumor thickness, as measured with Breslow's method, was inversely related to survival, as previously reported. We were able to define a low-risk group of patients, with tumor volume under 100 mm3. It appears that tumor volume, in addition to thickness and growth pattern, can contribute to the evaluation of vulvar melanoma. Evaluation of our findings in conjunction with those in the literature on cutaneous and vulvar melanomas led us to question the routine management of these lesions with radical vulvectomy plus inguinal and pelvic lymph node dissection.
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014625:Vaginal Neoplasms / Q000473:pathology; D014846:Vulvar Neoplasms / Q000473:pathology*