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Case Report Volume 5 Issue 2
Melanoma of vulva in a Nigerian
Wilson IB Onuigbo
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Department of Pathology, Medical Foundation and Clinic, Nigeria
Correspondence: Wilson IB Onuigbo, Department of Pathology, Medical Foundation and Clinic, 8 Nsukka Lane, Enugu 400001, Nigeria, Tel 2348037208680
Received: April 18, 2017 | Published: June 1, 2017
Citation: Onuigbo WIB, Eze JN. Melanoma of vulva in a Nigerian. MOJ Womens Health. 2017;5(2):206-207 DOI: 10.15406/mojwh.2017.05.00115
Abstract
Internet search for vulva melanoma revealed typical examples from several countries. The descriptions revealed the parameters such as the presentation at late stage among post-menopausal women with associated lichen sclerosus as well as the Caucasians having a 3-fold higher incidence rate than the individuals of African descent. Therefore, a single case found in a Nigerian among a cohort of over 100 pedal melanomas is deemed worthy of documentation.
Keywords: melanoma, vulva, IGBO, developing community
Introduction
Internet search for vulva melanoma produced recent publications from Australia,1,2 Sweden,3,4 USA,5 India6 and Italy.7 The highlights were late presentation in postmenopausal women due to lack of body awareness, false modesty and neglect as well as the Caucasians having a 3-fold higher incidence rate than the individuals of African descent. Therefore, a Nigerian of the Igbo ethnic group8 in whom vulvar melanoma occurred is deemed to be reportable.
Case report
IA, a para 1, 55-year-old Igbo woman attended the St. Mary’s Hospital, Enugu, Nigeria, with the history of itching of the right vulva associated with swelling and discharge of 2 months duration. Of shorter duration was inguinal swelling. Both areas were biopsied in continuity and sent to the senior author (WIBO) at a Reference Pathology Laboratory situated in Enugu also. The vulva-lymphadenectomy specimen was a 8 cm much distorted mass in which skin was scarcely identified. On section, black deposits abounded. Microscopy showed epithelial malignancy with much melanin deposition in skin, lymphoid tissue and surrounding fat. Malignant melanoma was diagnosed. Recovery was uneventful.
Discussion
Mucosal melanoma is a rare cancer that is clearly distinct from its cutaneous counterpart. Its literature was reviewed by Seetharmy et al.9 who described the three commonest sites of mucosal melanoma as the head and neck, the female genital tract, and the anorectum. Or, as Houghton et al.10 put it, “melanoma in darker races tends to occur on the foot and mucous membranes.” Accordingly, our vulva case is a good example of this generalization (Figure 1). In particular, at the age of 55 years, it compares favorably with the older Indian 75-year-old6 and the Italian 79-year-old.7 In conclusion, it is significant that a historical publication mentioned the age in a case of clitoris melanoma as 79 years.11 Incidentally, this Journal carried an account of it recently.12 Therefore, this related case deserves to appear in it!
Figure 1 Typical micrograph of melanoma.
Acknowledgements
None.
Conflict of interest
The author declares no conflict of interest.
References
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- Seetharamu N, Ott PA, Pavlick AC. Mucosal melanomas: A case-based review of the literature. Oncologist. 2010;15(7):772–781.
- Houghton AN, Viola MV. Solar radiation and malignant melanoma of the skin. J Am Acad Dermatol. 1981;5(4):477–483.
- Battle H. Primary melanotic sarcoma of clitoris. Trans Path Soc Lond. 1985;46:189.
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