Vulvar Malignant Melanoma: A Narrative Review

Area of Science:

• Gynecologic Oncology
• Dermatology
• Oncology

Background:

• Vulvar melanoma (VM) is a rare gynecological malignancy, comprising 5% of vulvar neoplasms.
• It predominantly affects older Caucasian women, with an unclear link to sun exposure.
• Diagnosis relies on biopsy, aided by clinical, dermatoscopic, and microscopic features.

Purpose of the Study:

• To review the clinical presentation, diagnostic methods, and molecular characteristics of vulvar melanoma.
• To discuss current treatment strategies and future therapeutic targets for VM.

Main Methods:

• Review of clinical, dermatoscopic, and confocal microscopic features for diagnosis.
• Analysis of molecular profiling using classical sequencing, next-generation sequencing, and immunohistochemistry.
• Evaluation of treatment outcomes and therapeutic options for primary and recurrent VM.

Main Results:

• The KIT mutation is a defining molecular feature of VM, consistently detected across various technologies.
• BRAF and NRAS mutations are also frequently observed in vulvar melanoma.
• Surgery is the primary treatment for initial VM, while neoadjuvant/adjuvant therapy roles and relapse management remain under investigation.

Conclusions:

• Vulvar melanoma presents unique diagnostic and therapeutic challenges due to its rarity.
• Molecular profiling, particularly KIT mutations, offers promising targets for future therapies.
• Further research is needed to establish optimal treatment protocols for VM, especially for recurrent disease.