Non-cutaneous primary malignant melanomas (extracutaneous melanomas) are rare tumors compared with the relative abundance of cutaneous melanomas. This differential is illustrated in (Table 1), which displays statistics for nearly all of the extracutaneous and cutaneous melanomas reported to the compulsory Swedish National Cancer Registry during a 40-year period (1960–1999) [1]. According to this registry, malignant melanomas of the vulva represent 7.6% of all vulvar malignancies (358 of 4736) [1]. By comparison, melanomas of the vagina accounted for 4% of the vaginal malignancies [1].