ABSTRACT
Clinical studies on the myriad of problems that are encompassed by pediatric and adolescent gynecologic surgery are extremely difficult to carry out due to the low numbers of patients with these diagnoses in any one location or institution. Our current understanding of diagnosis, treatment, and outcome is drawn from case reports and the sharing of information. Frequently, clinical practice embraces technology long before the reports of such technology appear in the literature. As clinicians join together to study the various pathologies seen in this group of patients, we may see some impressive studies in the future. This review will focus on the current information available, which may contribute to the treatment and understanding of pediatric and adolescent gynecologic surgery.
Subject(s)
Genital Diseases, Female/surgery , Adolescent , Anesthesia/methods , Child , Female , Genital Diseases, Female/diagnosis , Genitalia, Female/abnormalities , Gynecologic Surgical Procedures , Humans , Laparoscopy , Ovarian Diseases/surgery , Perineum/surgery , Vagina/surgeryABSTRACT
BACKGROUND: Malignant melanoma is rarely diagnosed during childhood. Approximately 2% of malignant melanomas occur in patients younger than 20 years, with 0.3% to 0.5% of cases occurring in prepubescent children. In adult females malignant melanoma of the vulva and vagina is 100-fold less common than malignant melanoma of nongenital skin. Malignant melanoma of the vulva occurring in a child has been reported once before. OBSERVATIONS: We report 2 cases of childhood vulvar malignant melanoma presenting in preteenage girls. In both cases, the lesions were asymptomatic enlarging hyperpigmented macules on the labium minus. In addition to features diagnostic of malignant melanoma, histological evidence of lichen sclerosus et atrophicus was identified in both lesions. Local excision with conservative margins was the treatment modality of choice in both cases, with good preservation of anatomic structure and function. CONCLUSIONS: This report is of 2 cases of vulvar melanoma in childhood, a rare, yet potentially devastating, presentation of melanoma. Biopsies on suspicious pigmented lesions on the vulva of prepubescent children should be done to rule out malignant change.
