EP1294\u2005Vulvar melanoma: case report

Abstract

Introduction/Background Melanoma, neoplasm originating in melanocytes 90% of them in skin and 1% originating in mucous membranes, including the ano-vagino-vulvar mucosa. Melanomas of primary gynecological origin are extremely rare tumors with reported incidences between 0.48 and 1.4 per 100,000; 70% of cases occur in vulva, followed by vagina and more rarely in cervix. With a 5-year overall survival that ranges from 30% to 50%.A peak incidence in the fifth or sixth decade of life, 75% of patients are diagnosed after 60 years. They have been described associated with mutations in a third of cases such as cKIT, NRAS and BRAF. A 45-year-old patient who consulted due to edema and erythema in the left hemivulva, a Bartholin gland abscess was diagnosed and marsupialized. It consults 3 days later finding persistence of inflammatory process and evidence of mass. A biopsy is taken which reports a poorly differentiated malignant tumor of large cells of poorly defined cytoplasms and large nuclei. Methodology We present a case report of a patient with vulvar melanoma. Results Clinical oncology indicated a BRAF mutation study to begining immunotherapy (Nivolumab vs Vemurafenib); 10 sessions of radiotherapy are indicated like palliative intent, with marked decrease in tumor size.Functional status of the patient progresses to deterioration Conclusion The behavior of a large simulator presented by melanomas, a homologated management is proposed between cutaneous melanomas and other types of melanoma in mucous membranes. Evidence is enough to support neoadjuvant management. The role of chemotherapy and immunotherapy is conditioned to immunohistochemical. Unresectable cases or recurrent disease or with nodal involvement, the use of radiotherapy is favored. Disclosure Nothing to disclose