Metastatic melanoma of the vulva identified by peritoneal fluid cytology

Malignant melanoma of the vulva is an uncommon disease, with a significant portion of cases demonstrating metastasis to inguinal lymph nodes with pote ntial distal spread identification of such metastases often requires fine-n eedle aspiration or biopsy. The cytologic diagnosis of metastatic vulvar me lanoma from peritoneal effusions has not been previously described, We pres ent the case of a 54-yr-old wolman who underwent en bloc radical vulvectomy with bilateral inguinal lymphadenectomy for melanoma of the right labium m inora. No evidence of metastatic disease was identified, and ail surgical m argins Ir er free of tumor: Despite chemotherapy, the patient returned appr oximately 2 yr Inter with abdominal pain and distention. Computed tomograph y revealed marked ascites ann three hepatic lesions, Cytologic examination of the ascites revealed recurrent, metastatic, melanoma. Although very rare , metastatic melanoma of the vulva mar present as a malignant effusion. In such an event, the diagnosis may be rendered by exfoliative cytology. (C) W iley-Liss, Inc.