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CASE REPORT
Recurrent vulvar melanoma in a patient with neurofibromatosis and gastrointestinal stromal tumour
  1. Anna Linehan,
  2. Emily Harrold,
  3. Keith Pilson and
  4. John McCaffrey
  1. Oncology, Mater Misericordiae University Hospital, Dublin, Ireland
  1. Correspondence to Dr Anna Linehan, anna.linehan{at}gmail.com

Abstract

We report a case of a 51-year-old woman with neurofibromatosis who presented in 2012 with postmenopausal bleeding. Excision biopsy of a pigmented lesion of the labia minora was consistent with an ulcerated vulvar BRAF wild type malignant melanoma (MM). Initial excision was followed by radical vulvectomy and adjuvant interferon. Local recurrence in January 2017 was further resected. Positron emission tomography (PET)-CT in May 2017 identified an FDG avid omental deposit; consistent histologically with MM when resected. Postoperative PET-CT in August 2017 demonstrated local recurrence. In the setting of resected stage IV disease and a third local recurrence, the decision was made to instigate immunotherapy. Vulvar melanoma is rare accounting for 0.2% of all melanoma. Presentation is typically a decade later than cutaneous melanoma with a tendency to late metastases and poorer prognosis. Given their rarity the treatment paradigm is less clearly defined and largely extrapolated from that of cutaneous melanomas.

  • skin cancer
  • dermatology
  • small intestine cancer
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Footnotes

  • Contributors AL reviewed the case and drafted the article. The report was revised critically by EH and JM. KP reviewed the slides of the various resections in the case. Final approval of the draft for publication was done by all contributing authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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