Postpartum Genital Melanoma – A Case Report

Nai, Gisele Alborghetti; A, Bazan; Rocha, Caroline Andrade; Nagy, Juliana Souza; Campos, Isadora Tanaka

doi:10.1055/s-0038-1624578

Cited by 6 publications

(7 citation statements)

References 8 publications

(12 reference statements)

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“… 16 , 17 , 18 In addition, cases where immunotherapy was administered exclusively before the gestational period or postpartum were also excluded. 19 , 20 , 21 , 22 From each one of those studies, the following data were extracted: first author, year of publication, type of immunotherapy administered during pregnancy, type of malignancy, patient age at diagnosis, patient age at pregnancy, gestational age (GA) at immunotherapy administration, total dose administered, GA at delivery, way of delivery (Cesarean section, etc. ), fetal outcome [prematurity, respiratory distress syndrome (RDS), congenital abnormalities etc.…”

Section: Methodsmentioning

confidence: 99%

Immune checkpoint inhibitor administration during pregnancy: a case series

et al. 2021

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Background: Immune checkpoint inhibitors have been widely implemented in current clinical practice. Although cancer occurs in w1 out of 1000 pregnancies, treatment remains challenging. Until now, limited data exist regarding immunotherapy administration during pregnancy. This systemic review aims to synthesize all available data from immunotherapy administration in pregnant women and evaluate the efficacy and safety of immunotherapy during pregnancy. Patients and methods: Eligible studies were identified by a search of the PubMed Medline database and Food and Drug Administration Adverse Events Reporting System Public Dashboard for the period 1 January 2000 to 1 April 2021; the algorithm consisted of a predefined combination of the words 'immunotherapy', 'cancer' and 'pregnancy'. PRISMA guidelines were applied in this study. Results: Overall, seven articles (seven pregnancies, nine neonates) were retrieved. The mean duration of immunotherapy administration was 9.8 weeks [standard deviation (SD): 11.27; median: 7.0; range: 1-32]. In all cases specified, melanoma was the malignancy reported. The mean gestational age at delivery was 30.4 weeks (SD: 5.03; median: 32.0; range: 24-38), whereas the mean weight of neonates at delivery was 1267 g (SD: 412.0; median: 1400; range: 590-1701). Only one neonate was born term at 38 weeks of pregnancy (11.1%; 1/9). Complications during pregnancy were observed in 71.4% of cases: intrauterine growth restriction (three cases), HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count) (one case), placental insufficiency (one case) and low fetal heart rate (one case). The mean progression-free survival and overall survival were 16.0 and 25.2 months, respectively. Conclusion:The administration of immune checkpoint inhibitors during pregnancy is associated with increased incidence of pregnancy complications, prematurity and low birth weight. The administration of these regimens is not recommended during gestation. Whenever applied, close monitoring of the mother and the fetus is required.

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Section: Methodsmentioning

confidence: 99%

Immune checkpoint inhibitor administration during pregnancy: a case series

et al. 2021

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“…The OS was 16 months in one patient with recurrent vaginal melanoma, 20–38 months in patients with non-recurrent vaginal melanoma, and 19 months in one patient with recurrent cervical melanoma. Table 3 summarizes the results of case reports [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ].…”

Section: Resultsmentioning

confidence: 99%

Current Status and Prospects of Immunotherapy for Gynecologic Melanoma

Anko

Kobayashi

Banno

et al. 2021

JPM

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Gynecologic melanomas are rare and have a poor prognosis. Although immunotherapy (immune checkpoint inhibitors) and targeted therapy has greatly improved the systemic treatment of cutaneous melanoma (CM) in recent years, its efficacy in gynecologic melanomas remains uncertain because of the rarity of this malignancy and its scarce literature. This review aimed to evaluate the literature of gynecologic melanomas treated with immunotherapy and targeted therapy through a PubMed search. We identified one study focusing on the overall survival of gynecologic melanomas separately and five case series and nine case reports concentrating on gynecologic melanomas treated with an immune checkpoint inhibitor and/or targeted therapy. Furthermore, the KIT mutation has the highest rate among all mutations in mucosal melanoma types. The KIT inhibitors (Tyrosine kinase inhibitors: TKIs) imatinib and nilotinib could be the treatment options. Moreover, immune checkpoint inhibitors combined with KIT inhibitors may potentially treat cases of resistance to immune checkpoint inhibitors. However, because of the different conditions and a small number of cases, it is difficult to evaluate the efficacy of immunotherapy and targeted therapy for gynecologic melanoma rigorously at this time. Further prospective cohort or randomized trials of gynecologic melanoma alone are needed to assess the treatment with solid evidence.

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“…PET (positron emission tomography) scan plays a role in the search for and confirming metastases. 16 CT of the pelvis showed an ovoid high-attenuation mass of vagina. 15 CT scan helped also to search for pelvic or paraaortic lymph node needed to improve classification.…”

Section: Discussionmentioning

confidence: 99%

Primary Malignant Melanoma of the Vagina without Metastasis: A Rare Case and Review of Literature

Bizimana¹,

Gloria²,

Insumbo

et al. 2021

ASJO

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Malignant melanoma of vagina is a rare condition. Its histogenesis has been debated and the positive diagnosis is based on immunohistochemistry. Pelvic magnetic resonance imaging remains the gold standard for assessing locoregional extension status and post-treatment surveillance of melanoma of vagina. The observation concerned a 53-year-old woman with no specific history who presented a primary malignant melanoma of vagina without secondary locations. To date, the case is the second one reported in the literature. Early diagnosis of the malignant melanoma of vagina may improve patient survival because late diagnoses are punctuated by poor prognosis. We have presented epidemiological with etiopathogenic characteristics and described all imaging features to stage the tumor and to conduct the appropriate treatment.

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Postpartum Genital Melanoma – A Case Report

Cited by 6 publications

References 8 publications

Immune checkpoint inhibitor administration during pregnancy: a case series

Immune checkpoint inhibitor administration during pregnancy: a case series

Current Status and Prospects of Immunotherapy for Gynecologic Melanoma

Primary Malignant Melanoma of the Vagina without Metastasis: A Rare Case and Review of Literature

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