An Unusual Place For a An Unusual Place For a MelanomaMelanoma

Salt Lake Valley Health DepartmentSalt Lake Valley Health DepartmentSTD ClinicSTD Clinic

• A 28 year old female came to the A 28 year old female came to the clinic complaining of abnormal clinic complaining of abnormal vaginal discharge and genital vaginal discharge and genital irritation. She had no other irritation. She had no other complains. She had a steady partner complains. She had a steady partner and no history of any sexually and no history of any sexually transmitted diseases. transmitted diseases.

• During the pelvic exam a 1.5 cm During the pelvic exam a 1.5 cm lesion was noted above the clitoris lesion was noted above the clitoris and she had non-tender bilateral and she had non-tender bilateral lymphadenopathy. lymphadenopathy.

• The vaginal discharge was normal The vaginal discharge was normal and no other problems were noted. and no other problems were noted. All STD test results were negative.All STD test results were negative.

• The patient was questioned about the lesion The patient was questioned about the lesion and she gave a history of a mole that she and she gave a history of a mole that she had there for many years that had recently had there for many years that had recently changed and was causing some irritation. changed and was causing some irritation.

• Note that the patient did not come in Note that the patient did not come in because of the lesion but for the discharge because of the lesion but for the discharge and irritation. We did not ask when she had and irritation. We did not ask when she had her last pelvic exam. her last pelvic exam.

• The patient was immediately The patient was immediately referred to the University of Utah and referred to the University of Utah and was seen the next day by one of the was seen the next day by one of the Dermatologists.Dermatologists.

• That day she received an excision That day she received an excision biopsy.biopsy.

• Multiple follow up calls were made to Multiple follow up calls were made to the patient but she did not return the patient but she did not return any of our calls. We did receive any of our calls. We did receive information from the dermatologist information from the dermatologist that the lesion was a melanoma.that the lesion was a melanoma.

• We continued to have concern for We continued to have concern for the patient but she did not return our the patient but she did not return our calls so 7 months later we checked calls so 7 months later we checked with vital records and found a death with vital records and found a death certificate for the patient with the certificate for the patient with the cause of death listed as metastasized cause of death listed as metastasized melanoma.melanoma.

DisclaimerDisclaimer

• Copyright all clinical photos: Copyright all clinical photos: – Cammie Barrus, APRN, Salt Lake Valley Cammie Barrus, APRN, Salt Lake Valley

Health Department, STD Clinic.Health Department, STD Clinic.

• Individual slides can be used for Individual slides can be used for educational purposes with reference educational purposes with reference to source. to source.