Hymenal tag; a clue to the diagnosis of vaginal polyp: A case report of primary vaginal melanoma mimicking an undifferentiated pleomorphic sarcoma

Abstract

Primary malignant melanoma of the vagina accounts for less than 0.3% of all melanomas and approximately 4% of vaginal malignancies. We present a case of a 61-year-old female who presented with complaints of difficulty in urination and a polyp arising from the vagina. Local examination showed a polyp arising from the lateral vaginal wall and a hymenal tag. Histopathological examination of the polyp showed a neoplasm simulating a pleomorphic sarcoma. The hymenal tag showed classical features of malignant melanoma. Immunohistochemistry with S100 and HMB45 confirmed malignant melanoma in the vaginal polyp. We report this case, on account of its rarity and unusual phenotypic profile, which may lead to a delayed or alternate diagnosis. Primary malignant melanoma of the vagina needs early accurate diagnosis and management due to its aggressive nature.