Primary Vaginal Amelanotic Melanoma

Abstract

Summary Objective Primary vaginal melanoma is a very rare tumor entity, with a poor prognosis. The diagnosis is evident when melanin pigment is present within the tumor. However, the diagnosis of an amelanotic melanoma is problematic and should be differentiated from other conditions such as sarcoma, adenocarcinoma or small cell carcinoma. We present a patient with abnormal vaginal bleeding, with a diagnosis of amelanotic melanoma of the vagina confirmed by immunohistopathologic examination. Case Report A 78-year-old woman was brought to our hospital because of postmenopausal vaginal bleeding for several days. Physical examination revealed two erythematous nodules, about 1 cm in size, in the upper-third of the vagina. Biopsy of the vaginal tumor showed a high-grade sarcoma. She underwent a wide local excision of the lesion, and histology confirmed the diagnosis of amelanotic melanoma due to strong staining of Melan-A. Conclusion The diagnosis of amelanotic melanoma of the vagina is sometimes difficult. Immunohistochemistry may be required to provide additional diagnostic information in problematic cases.