Vulvar Malignant Melanoma: A Narrative Review
Giovanni Falcicchio, Lorenzo Vinci, Ettore Cicinelli, Vera Loizzi, Francesca Arezzo, Erica Silvestris, Leonardo Resta, Gabriella Serio, Gerardo Cazzato, Marialuigia Mastronardi, Michele Mongelli, Marco Marinaccio, Gennaro Cormio
Abstract
Malignant melanoma is a fatal disease that affects all skin sites. Among these, vulvar melanoma (VM) is a rare gynecological condition that accounts for 5% of all vulvar neoplasms. VM primarily affects older Caucasian women and its relationship to sun exposure is undefined. Diagnosis is defined by biopsy but many clinical, dermatoscopic, and confocal microscopic features can guide doctors. The molecular profile is characterized by the KIT mutation, revealed by all of the technologies that are used (classical sequencing, next-generation sequencing, and immunohistochemical staining). BRAF and NRAS mutations are also common in VM. All of these mutations are possible therapeutic targets. Today, surgery remains the first treatment choice for primary VM. The role of neoadjuvant and adjuvant therapy is scarce and the treatment of relapses is widely debated.