Primary Malignant Melanoma of the Female Genital Tract

Abstract

Malignant melanoma, which has a highly malignant potential, is a tumor of the skin and mucosal membranes. Malignant melanomas of the female genital tract, including the vulva and vagina, are rare. Their overall prognosis is poor and is worse than that for cutaneous melanomas. Clinical data for five patients with primary malignant melanoma are presented. Diagnosis was based on histologic and immunohistochemical examinations. Case 1 was a 58-year-old woman with mucosal lentiginous melanoma of the vulva. The other four patients, all of whom were over 40 years old, had vaginal melanomas. They were all treated with surgery, and three also received postoperative adjuvant therapy with interferon alpha-2b. Despite this, three of the patients died owing to widespread disease. Although malignant melanoma of the female genital tract is uncommon, elderly women should undergo regular gynecologic examinations and suspicious pigmented lesions should be biopsied. The use of immunohistochemical assays could markedly improve diagnosis. However, the prognosis for these tumors is poor, regardless of the treatment delivered, and they are associated with a high rate of recurrence and low long-term survival. Surgery is the best available treatment for controlling and potentially curing malignant melanomas.