Pregnancy Complicated by Rapidly Progressing Vulvar Melanoma: A Case Study.

Area of Science:

• Obstetrics and Gynecology
• Dermatology
• Oncology

Background:

• Vulvar melanoma during pregnancy is exceptionally rare.
• Pregnancy-associated hormonal and immunological shifts may influence melanoma behavior.
• Concerns exist regarding accelerated melanoma progression and maternal outcomes in pregnant patients.

Observation:

• A 40-year-old pregnant patient (28 weeks gestation) with a history of vulvar melanoma presented with abdominal pain and hematuria.
• Examination revealed a vulvar mass, cervical mass on ultrasonography, and elevated lactate dehydrogenase (LDH).
• The patient had received prior chemotherapy for vulvar malignant melanoma.

Findings:

• The patient underwent cesarean hysterectomy with colpotomy and bladder repair due to advanced metastatic vulvar melanoma involving the cervix and uterine corpus.
• Pregnancy was terminated at 27 weeks due to grade IV melanoma progression; the neonate was delivered in stable condition.
• The patient died one month post-operation.

Implications:

• This case underscores the potential for aggressive melanoma progression during pregnancy.
• Despite the aggressive nature of the disease, a favorable fetal outcome was achieved.
• The case illustrates the complex interplay between pregnancy and cancer progression, and the potential for conception after chemotherapy.