DESMOPLASTIC MELANOMA OF THE VULVA

The clinical and pathological features of a nonulcerated desmoplastic melanoma in the vulva of a 52-year-old woman are presented, Pleomorphi c neoplastic spindle cells, fibroblasts and collagen formed a poorly d emarcated 18 mm dermal mass. No adjacent intraepidermal component was seen. Immunoreactivity was demonstrated for S100 protein, vimentin, ne uron-specific enolase and actin, but not for HMB-45, CAM 5.2, cytokera tin, epithelial membrane antigen, desmin or CD34. Electron microscopic examination was noncontributory, Treatment included a left hemivulvec tomy with ipsilateral groin node dissection followed by radiotherapy, The tumor recurred six weeks later and was unresectable. The patient i s alive with symptoms nine months after presentation. This is the firs t case report of a vulvar desmoplastic melanoma without neural involve ment or an intraepidermal component. The variable tumor cytomorphology , nonspecific immunohistochemical and ultrastructural features render a diagnosis more difficult than with other primary cutaneous melanomas .