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. 2013:2013:137908.
doi: 10.1155/2013/137908. Epub 2013 Jul 22.

Vaginal primary malignant melanoma: a rare and aggressive tumor

Georgios Androutsopoulos  1 , Emmanouil Terzakis, Georgia Ioannidou, Athanasios Tsamandas, Georgios Decavalas
Affiliations

Vaginal primary malignant melanoma: a rare and aggressive tumor

Georgios Androutsopoulos et al. Case Rep Obstet Gynecol. 2013.

Abstract

Vaginal primary malignant melanoma is a rare and very aggressive tumor. It most commonly occurs in postmenopausal women, with a mean age of 57 years. Our patient is an 80-year-old, postmenopausal Greek woman presented with a complaint of abnormal vaginal bleeding. On gynecologic examination there was a pigmented, raised, ulcerated, and irregular lesion 5 × 4.5 cm in the upper third of anterior vaginal wall. She underwent a wide local excision of the lesion. The histopathology revealed vaginal primary malignant melanoma with ulceration and no clear surgical margins. She denied any additional surgical interventions and underwent to postoperative adjuvant radiotherapy. Follow up 5 months after initial diagnosis revealed no evidence of local recurrence or distant metastasis. The prognosis of vaginal primary malignant melanoma is very poor despite treatment modality, because most of the cases are diagnosed at advanced stage. Particularly patients with no clear surgical margins and tumor size >3 cm needed postoperative adjuvant radiotherapy.

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Figures

Figure 1
Figure 1
(a, b) Histologic details from tumor. The predominant cell type was epithelioid (red arrows) and not spindle cell. There were also multinuclear giant cells (yellow arrow) and abundant melanin deposition (green arrow) (H&E (a) ×200, (b) ×400). (c, d) Immunophenotype of tumor cells. The neoplastic cells expressed tyrosinase (blue arrows) (Streptavidin peroxidase (c) ×200, (d) ×400).
Figure 2
Figure 2
Tumor and vaginal epithelium. The arrows in (a, b) point the squamous cell epithelium of the vagina. The arrows in (c, d) point out the ulceration that tumor caused in the vaginal epithelium (H&E (a, c) ×200, (b, d) ×400).
Figure 3
Figure 3
Immunophenotype of tumor cells. The neoplastic cells expressed melan A ((a, b) red arrows) and S-100 ((c, d) red arrows) (Streptavidin peroxidase (a, c) ×200, (b, d) ×400).
Figure 4
Figure 4
Immunophenotype of tumor cells The neoplastic cells expressed HMB45 ((a, b) red arrows) and microphthalmia transcription factor (MITF) ((c, d) red arrows) (Streptavidin peroxidase (a, c) ×200, (b, d) ×400).
See this image and copyright information in PMC

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