Primary Cervical Malignant Melanoma: 2 Cases and a Literature Review

Abstract

Primary cervical malignant melanoma (MM) is an extremely rare tumor, and we are only aware of 44 reported cases. Further information is needed with regard to this disease's clinicopathologic features. Two patients (55 and 81 yr old) with postmenopausal vaginal bleeding were diagnosed with primary cervical MM on the basis of hematoxylin-eosin staining and immunohistochemistry findings. Our literature review revealed that the average age in cases of primary cervical MM was 59 yr (range, 34-81 yr); 93% of patients presented with vaginal bleeding, and 82% of patients were diagnosed at an early clinical stage (International Federation of Gynecology and Obstetrics stages I-II). Primary cervical MM is an extremely rare cervical tumor and is associated with a poor prognosis. Histologic morphology and immunohistochemistry are very important considerations for diagnosing this disease, which must be differentiated from cervical undifferentiated carcinoma, leiomyosarcoma, and malignant peripheral schwannoma.

Primary Melanoma of the Cervix Uteri: A Systematic Review and Meta-Analysis of the Reported Cases

“…In the exclusion phase, seven studies (five retrospective cohorts and two prospective cohorts) that included 51 cases with primary MM of the cervix were excluded from the review because they did not provide individual patient data ( Table S1 ). Finally, 96 studies [ 4 , 7 , 10 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , …”

“…Chemotherapy with or without radiotherapy has been used sporadically as primary treatment in cases of unresectable tumors or patients with advanced disease [ 21 ]. Their effectiveness as adjuvant agents to surgery remains controversial, although many authors have used the aforementioned approach in patients with positive surgical margins or parametrial involvement [ 21 ]. Finally, immunotherapy and biological therapy have emerged the last decade as promising options for patients with primary MM of the cervix.…”

Primary malignant melanoma of the cervix: A comprehensive analysis of case reports in the Chinese population

“…Following the search, 71 articles in four databases were eligible, including 165 cases. Table S1 lists the main attributes of participating patients 8–78 ; these include Authors, Age, Symptom, Figo, Lymph node metastasis, Chemotherapy, Radiotherapy, Immunotherapy, Survival(m), Status, HPV infection. The main clinical manifestations were vaginal bleeding and vaginal discharge.…”

“…In the current study, the vast majority of patients underwent RH‐based surgery and they had a longer median survival time than patients without surgery or TAH‐based surgery; therefore, RH‐based surgery is recommended for PMMC. Radiation therapy is mainly used for those patients who are unsuitable for surgery, for palliative treatment of advanced patients, or as adjuvant therapy and neoadjuvant therapy 75 . It can also be used as preoperative radiotherapy in locally advanced patients to reduce tumor size, so that conservative surgery can then be implemented 88 .…”

A case of primary malignant melanoma of the female genital tract involving both the cervix and vagina

“…The etiology and pathogenesis of melanoma are poorly understood, and its clinical manifestations are nonspecific. Cervical melanoma is clinically characterized by irregular vaginal bleeding, postmenopausal vaginal bleeding, and increased vaginal discharge ( 7 ). Cervical pigmentation can be observed via colposcopy.…”