Abstract
Primary vaginal malignant melanoma is an extremely rare and aggressive tumor with very few reported cases worldwide. It often occurs in post-menopausal women, with a mean age of 57 years. The most common presenting symptom is vaginal bleeding. Other less common presenting symptoms are vaginal discharge, vaginal mass, and pain. Vaginal melanomas are often diagnosed at an advanced stage, and despite the aggressive treatment approach, the prognosis is poor. We present to you a case of a 56-year-old post-menopausal woman who presented with intermittent vaginal bleeding and passage of dark clots. She was found to have symptomatic anemia requiring blood transfusions. Further workup revealed a mass in the upper vagina on imaging studies, and the patient eventually underwent a biopsy, which confirmed the diagnosis of malignant melanoma of the vagina on pathological examination.
Highlights
Primary vaginal malignant melanoma is an infrequent entity, with less than 250-300 cases reported in the literature, accounting for only 0.46 cases per million women per year [1,2]
It seems to be evident that ultraviolet radiation exposure is not a causative factor, in contrast to cutaneous malignant melanoma, given the areas are less exposed
We present a 56-year-old-female with primary vaginal melanoma and a review of the literature
Summary
Primary vaginal malignant melanoma is an infrequent entity, with less than 250-300 cases reported in the literature, accounting for only 0.46 cases per million women per year [1,2]. We present a 56-year-old-female with primary vaginal melanoma and a review of the literature. The symptoms were associated with shortness of breath upon exertion, dizziness, and weakness She had a history of three previous cesarean sections and reported being told that she had fibroids in 1994. Computerized tomography scan of the abdomen and pelvis with contrast showed a large mass centered in the upper vagina compatible with vaginal or cervical malignancy along with metastatic pelvic and lower retroperitoneal adenopathy (Figures 1 and 2).
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