Vulvar melanoma in childhood
C. A. Egan, R. R. Bradley, V. K. Logsdon, B. K. Summers, G. R. Hunter and S. L. Vanderhooft
Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, USA.
BACKGROUND: Malignant melanoma is rarely diagnosed during childhood.
Approximately 2% of malignant melanomas occur in patients younger than 20
years, with 0.3% to 0.5% of cases occurring in prepubescent children. In
adult females malignant melanoma of the vulva and vagina is 100-fold less
common than malignant melanoma of nongenital skin. Malignant melanoma of
the vulva occurring in a child has been reported once before. OBSERVATIONS:
We report 2 cases of childhood vulvar malignant melanoma presenting in
preteenage girls. In both cases, the lesions were asymptomatic enlarging
hyperpigmented macules on the labium minus. In addition to features
diagnostic of malignant melanoma, histological evidence of lichen sclerosus
et atrophicus was identified in both lesions. Local excision with
conservative margins was the treatment modality of choice in both cases,
with good preservation of anatomic structure and function. CONCLUSIONS:
This report is of 2 cases of vulvar melanoma in childhood, a rare, yet
potentially devastating, presentation of melanoma. Biopsies on suspicious
pigmented lesions on the vulva of prepubescent children should be done to
rule out malignant change.
