Primary Vaginal Melanoma – Cytohistological Correlates and Literature Reviews

Abstract

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).

Primary malignant melanoma of the vagina: A case report and a mini review

“…Diagnosing malignant melanoma by cytological evaluation is difficult, since melanoma is a great mimicker and can present with a variety of cytological features. 10 Thus, the diagnosis of vaginal melanoma is usually established by histology and immunohistochemistry. 3 Histologically, the cells of a mucosal melanoma may be epithelioid, spindle-shaped or both types.…”