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Melanomas represent a small percentage of skin malignancies, but they represent the majority of deaths from skin cancer. The etiology of vulvar melanomas may differ from other melanomas, where the most important risk factor is exposure to ultraviolet light. Compared to adults, pediatric melanomas have an atypical clinical presentation, posing as low-suspicion lesions, thus leading to a diagnostic delay and increased mortality in this patient population.

A 10-year-old female with a painful hyperpigmented lesion localized in the left vulvar region, with no other associated symptoms. Dermatology assessment described a palpable neoformation of 5 × 6 mm, black color, with irregular borders. Dermoscopy shown asymmetrical pattern, peripheral globules, irregular projections, and blue-white veil. Subsequently, an excisional biopsy of the lesion was performed, with a histopathological report of melanoma HMB45 positive, p-53 positive and focal Ki-67, negative margins. Further studies revealed no evidence of metastatic activity; therefore, it was decided to continue medical surveillance by the pediatric oncology service.

Vulvar melanoma is a malignant entity with a low incidence rate. There are no case reports published in Mexico that describe its location in the pediatric population. Given the high mortality, early diagnosis and treatment would improve life expectancy in our patients.