Melanoma is an aggressive malignancy of pigment-producing cells known as melanocytes. Melanoma may arise at sites of melanocytes including on the skin, mucous membranes, around the nail apparatus, and in the eye. Mucosal melanomas account for 1% of all melanomas and carry a poorer prognosis in general than cutaneous melanoma. Vulvovaginal and cervical melanomas account for 1%-3% of all melanomas in women. Cervical, urethral, and bladder melanomas are exceedingly rare. Vaginal and cervical melanomas have been associated with a poorer prognosis than vulvar melanomas independent of stage at presentation and lymph node involvement.

Vulvar, vaginal, and cervical melanomas have been reported in women in the third to ninth decade of life, but most develop these melanomas in their sixth to seventh decade. Vulvar melanoma may arise de novo or from a preexisting nevus.

Vaginal and cervical melanomas are often difficult to detect and therefore tend to be diagnosed late. Melanoma in this location may be asymptomatic or present with pain, bleeding, or dyspareunia. Urethral melanomas are similarly difficult to visualize and may present with urethral bleeding or hematuria.