Vulvar mucosal melanoma is a form of cancer that develops in the cells of the mucus membranes in the vulva. Symptoms include unexpected bleeding, vaginal pain, unusual discharge, itching, and a lump or growth.

Melanoma is a type of skin cancer that begins in cells called melanocytes. Although most melanomas develop in areas of the body that have exposure to the sun, they can develop anywhere on the body, including the vulva.

This article provides an overview of vulvar mucosal melanoma. It details its symptoms and stages and discusses the risk factors, diagnosis, and treatment options.

Vulvar mucosal melanoma is a rare form of cancer. Vulvar mucosal melanoma is a rare form of cancer. A 2020 narrative review indicates that just 0.2% of 100,000 women will develop this condition.

Vulva melanomas are the second most common cancer to affect the vulva. Research has shown that only around 1% of all melanomas begin in the female genital tract. Of those, roughly 76% start in the vulva.

Learn all about melanomas.

Vulvar mucosal melanoma can develop anywhere on the vulva but most commonly develops on the clitoris or inner lips (labia).

Vulvar mucosal melanoma may not present with any symptoms. For those who do experience symptoms, they may have the following:

  • vulval itching
  • unexpected vaginal bleeding
  • atypical vaginal discharge
  • a lump or growth in or on the vulva
  • an open sore

Some people may develop swollen lymph nodes when the cancer is in its later stages.

Anyone with symptoms of vulvar mucosal melanoma should seek a doctor’s advice.

Learn more about vulvar cancer.

Staging for vulvar mucosal melanoma is similar to the staging system used for skin melanoma. The American Cancer Society (ACS) notes that healthcare professionals typically use the American Joint Committee on Cancer TNM system to stage vulvar melanoma.

This staging system is based on the following information:

  • the extent of the tumor (T), including its size and level of ulceration
  • how far it has spread to nearby lymph nodes (N)
  • the spread to distant areas of the body, or metastasis (M)

The stages are as follows:

0The cancer is present in the outermost layer of the skin.

It has not spread to any nearby lymph nodes.

It has not spread to distant parts of the body.
IThe tumor measures up to 2 millimeters (mm), and ulceration may or may not be present.

The cancer has not spread to any nearby lymph nodes.

The cancer has not spread to distant parts of the body.
2The tumor measures more than 1 mm and may measure more than 4 mm. The tumor may or may not be ulcerated.

The cancer has not spread to nearby lymph nodes.

The cancer has not spread to distant parts of the body.
3Stage 2 consists of 4 substages and can be complex.

Stage 2A consists of a tumor that measures more than 2 mm thick. By stage 3D, the tumor measures more than 4 mm.

At stage 3A, the cancer has spread to nearby lymph nodes, or only tiny parts have spread. By stage 3D, there is more significant lymph node involvement.

Stage III vulvar mucosal melanoma has not spread to distant parts of the body.
4The tumor can be any thickness and may or may not be ulcerated.

The cancer may or may not have spread to lymph nodes.

The cancer has spread to distant lymph nodes or other organs.

Understanding the stages of vulvar mucosal melanoma can be challenging. A person can speak with their doctor to understand their cancer stage and what this means.

Learn more about cancer stages and how they develop.

As with any cancer, vulvar mucosal melanoma develops when cells grow abnormally. However, doctors do not know what causes these changes.

The 2022 review suggests that it is more likely to affect white females between the ages of 50 to 80 years.

A person may also have a higher chance of developing the condition if they have a family history of melanoma.

Learn more about genetic cancers.

A healthcare professional will perform a physical exam to diagnose and stage vulvar mucosal melanoma. If doctors spot a lesion on someone’s vulva, they may request a biopsy. This involves surgically removing a sample of the lesion before sending it for testing in a laboratory.

Doctors will want to run further tests if the laboratory test indicates that someone has vulvar mucosal melanoma. These can help to determine the extent to which the cancer has spread, which is important for staging.

These exams include blood and imaging tests, such as a CT or MRI scan, of the pelvis, abdomen, and chest.

Find out whether a blood test can diagnose cancer.

Treatment depends on:

  • the size of the tumor
  • the location of the cancer
  • the spread of the cancer
  • a person’s overall health

Surgery is the primary form of vulvar mucosal melanoma treatment. A surgeon will perform a wide local excision. This involves removing as much of the tumor as possible. Surgeons may also want to remove nearby lymph nodes in the groin.

A person may also require additional treatments, such as:

However, according to a 2020 review, surgery is the treatment most likely to control vulvar mucosal melanoma. However, immunotherapies are promising treatments that require further research.

Learn about some other alternatives to chemotherapy.

The survival rate for vulva mucosal melanoma depends on whether or not the cancer has spread to the lymph nodes.

Estimates indicate that if the cancer has not spread to lymph nodes, the 5-year survival rate is 65.2%. If the cancer has spread to the lymph nodes, a person may have a 5-year survival rate of 26.8%.

It is important to remember that these figures are estimates. A person can speak with a doctor to learn more about their cancer.

Learn about the most curable cancers.

Is it curable?

Research has shown that doctors can sometimes cure vulvar mucosal melanoma with surgery.

Vulvar mucosal melanoma is a rare cancer that begins in the vulva. It can cause vulvar lumps, itchiness, bleeding, and unusual discharge. Doctors diagnose and stage this condition with biopsies and scans.

The only proven treatment for vulvar mucosal melanoma is surgery. Although it can be effective, the survival rate for this cancer is relatively low.

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