Primary Malignant Melanoma of Vagina – A Case Report with Review of Literature

Ghosh, Arnab; Pradhan, Sarita; Swami, Ravi; Kc, Sr; Talwar, OP

doi:10.31729/jnma.269

Cited by 5 publications

(6 citation statements)

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“…9 No data on incidence of melanoma in Nepal were available except for only a few reported cases of melanoma in vagina, eyes and nasal cavity. 7,10,11 In the study conducted by Nagore E et al in Spain, the total number of cases enrolled in the study was 1571 over a period of 18 years. 8 But in the study conducted by Hui S K et al in Hong Kong Chinese patients over a period of 12 years, the total number of cases was only 32.…”

Section: Discussionmentioning

confidence: 99%

Clinico-pathological Study of Malignant Melanoma in A Tertiary Care Centre

et al. 2017

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Introduction: Malignant melanoma, which causes three fourth of all deaths related to skin cancer, is more common in Caucasian population compared to Asian population. There is no reliable information about malignant melanoma in Nepal hence an effort has been made to assess the clinical and pathological features of melanoma patients. Methods: This was a retrospective hospital based study done in the department of Pathology. All cases of malignant melanoma diagnosed on biopsy during a period of 13 years were retrieved, reviewed and collated. Results: We had 35 cases with age range from 15 to 84 years with the mean of 51.4 years and M: F of 1.3:1. The predominant site was lower extremities. Most cases were less than 3 cm. Majority of histologic subtypes were nodular melanoma 29 (82.8%) followed by mucosal lentiginous melanoma 3 (8.6%), superficial spreading melanoma 2 (5.7%) and acral lentiginous melanoma 1 (2.9%). Half (50%) of the excisional biopsies were at Clark’s level IV and 75% were at high Breslow thickness. Conclusions: The most frequent site in males and females were lower extremities and trunk respectively in contrast to Western studies where it is opposite. Nodular melanoma was the commonest histologic subtype while in other Asian studies and in Western studies majority were acral lentiginous melanoma and superficial spreading melanoma respectively. Keywords: Breslow thickness; Clark’s level; malignant melanoma; nodular melanoma.

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confidence: 99%

Clinico-pathological Study of Malignant Melanoma in A Tertiary Care Centre

et al. 2017

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“…Diagnosing malignant melanoma in Pap smear is difficult. Hence the disease itself is uncommon happen to female genital tract with less than 300 cases have been reported throughout the world [4]. However, in this case Pap smear test is playing a big role as a screening tool in diagnosing a pre-cancerous lesion and cancerous lesion.…”

Section: Discussionmentioning

confidence: 99%

“…Big tumour size and evidence of lymph nodes metastases associated with poor prognosis; however surgical removal of gross tumour will improved clinical outcome [2,[5][6][7]. Vaginal melanoma is a very aggressive tumour and the overall prognosis is very poor despite the treatment modality given [4] (Figures 6-8).…”

Section: Discussionmentioning

confidence: 99%

“…Chemotherapy was started. of cytological features like clear cell, spindle cells, signet ring cells and even plasmacytoid [4]. To distinguish between melanoma and carcinoma cannot be rule out on Pap smear test alone.…”

Section: Case Summarymentioning

confidence: 99%

“…There is no defined, yet appropriate and effective protocol for this disease. Recommended treatment varies from wide local excision, radical surgery, radiotherapy, chemotherapy and immunotherapy [4]. This aggressive tumour has a poor prognosis, with 5 year survival rates 5 -25% [1].…”

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confidence: 99%

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Primary Vaginal Melanoma Ã¢ÂÂ Cytohistological Correlates and Literature Reviews

Zin¹

2015

Gynecol Obstet (Sunnyvale)

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Malignant melanoma is a well known high grade tumor but with slowly progressing malignancy. Primary malignant melanoma is a rare, highly malignant and has a poor prognosis disease.A 54-years-old, pre-menopause female presented with a mass coming out of vagina with foul smelling vaginal discharge and prolonged vaginal bleeding for 3 months. On per speculum examination, there was a friable greyish fungating mass measures 5×3 cm in size with contact bleeds which predominantly involved the vagina.Pap smear was done and reported as carcinoma (NOS). Later, biopsies were done at various sites around cervix, vaginal mass, left vaginal tumour margin and endometrial. Cervical and endometrial biopsies show no evidence of malignancy. However, the biopsy from vaginal mass reported as malignant melanoma of vagina. The left vaginal wall margin also shows tumour involvement.The patient was received an external pelvic radiotherapy. CT scan staging shows the malignant tumour has metastasized to the lung and liver. Currently patient is under chemotherapy follow up. Figure 1: Shows a cluster of malignant cells (Pap x400).

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Case report: a robotic-vaginal approach for total vaginectomy and hysterectomy with pelvic sentinel lymph node dissection in primary vaginal melanoma: a 10-step technique and literature review

Van Trappen,

Lebbe,

De Cuypere

et al. 2023

Front. Surg.

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IntroductionPrimary vaginal melanoma is extremely rare, has a poor prognosis, and occurs mostly in elderly women. The diagnosis is based on histology and immunohistochemistry of a biopsy. Given the rarity of vaginal melanoma, no standardized treatment guidelines are established; however, surgery is the primary treatment modality in the absence of metastatic disease. Most reports in the literature are retrospective single cases, case series, and population-based studies. The open surgical approach is the main modality reported. Here, we report for the first time a 10-step combined robotic-vaginal technique, with en bloc resection of the uterus and total vagina, for treating clinically early-stage primary vaginal melanoma. In addition, the patient in our case underwent a robotic pelvic bilateral sentinel lymph node dissection. The literature on the surgical approach for vaginal melanoma is reviewed.Case presentationA 73-year-old woman was referred to our tertiary cancer center and was clinically staged according to the 2009 International Federation of Gynaecology and Obstetrics (FIGO) staging for vaginal cancer as FIGO-stage I (cT1bN0M0) and according to the American Joint Committee on Cancer (AJCC) for (cutaneous) Melanoma Staging as clinical stage IB. Preoperative imaging with magnetic resonance imaging, FDG-positron emission tomography-computed tomography, and ultrasound of the groins did not reveal any adenopathy nor metastases. The patient was planned for a combined vaginal and robotic en bloc total vaginectomy and hysterectomy, as well as a pelvic bilateral sentinel lymph node dissection.ResultsThe surgical procedure was performed in 10 steps described in this case report. The pathology revealed free surgical margins and negative test results for all sentinel lymph nodes. The postoperative recovery process was uneventful, and the patient was discharged on day 5.ConclusionThe main surgical approach reported for primary early-stage vaginal melanoma is open surgery. A minimally invasive surgical approach, described here as a combined vaginal-robotic en bloc total vaginectomy and hysterectomy, for the surgical treatment of early-stage vaginal melanoma enables precise dissection, low surgical morbidity, and fast recovery for the patient.

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Primary Malignant Melanoma of Vagina – A Case Report with Review of Literature

Abstract: abstracten

Cited by 5 publications

References 2 publications

Clinico-pathological Study of Malignant Melanoma in A Tertiary Care Centre

Clinico-pathological Study of Malignant Melanoma in A Tertiary Care Centre

Primary Vaginal Melanoma Ã¢ÂÂ Cytohistological Correlates and Literature Reviews

Case report: a robotic-vaginal approach for total vaginectomy and hysterectomy with pelvic sentinel lymph node dissection in primary vaginal melanoma: a 10-step technique and literature review

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Primary Malignant Melanoma of Vagina – A Case Report with Review of Literature

Abstract: abstracten

Cited by 5 publications

References 2 publications

Clinico-pathological Study of Malignant Melanoma in A Tertiary Care Centre

Clinico-pathological Study of Malignant Melanoma in A Tertiary Care Centre

Primary Vaginal Melanoma Ã¢ÂÂ Cytohistological Correlates and Literature Reviews

Case report: a robotic-vaginal approach for total vaginectomy and hysterectomy with pelvic sentinel lymph node dissection in primary vaginal melanoma: a 10-step technique and literature review

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Primary Vaginal Melanoma Ã¢ÂÂ Cytohistological Correlates and Literature Reviews