Vaginal melanoma
| Vaginal melanoma | |
|---|---|
| Specialty | Oncology/gynecology |
Vaginal melanoma is a rare malignancy that originates from melanocytes in the vaginal epithelium. It is also known as a melanocytic tumor or as a malignant melanoma.[1] It is aggressive and infrequently cured. The median overall survival is 16 months.[2] Vaginal melanoma accounts 5.5% of all vaginal cancers and only 1% of all melanomas diagnosed in women.[2] Vaginal melanomas are frequently diagnosed in advanced stages of the disease. The prognosis is poor and the most important risk factor is the presence of lymph node metastases.[2][3]
Presentation
This cancer most often develops on the lowest third of the vagina. It is darkly pigmented and of an irregular T-shape, but amelanotic melanomas have been describedin 7%. Melanoma of the vagina can be several centimeters in size.[2][3]
Histology
When the tissue is assessed, the histological characteristics include:
- the shape of the cells appear similar to epithelial and spindle-shaped
- the growth occurs in the shapes of sheets and nests
- the presence of melanin in the cells
- the nucleus of the cells is large and abnormal
Other cancers
Other cancerous conditions arise from vaginal epithelium:[4]
- Vaginal squamous-cell carcinoma arises from the squamous cells of the vaginal epithelium[5]
- Vaginal adenocarcinoma arises from secretory cells in the vaginal epithelium
- Clear cell adenocarcinoma of the vagina this malignancy arises in some women prenatally exposed to diethylstilbestrol[6][7]
Diagnosis
A biopsy should be obtained from all suspicious lesions and Immunocytochemistry can reveal positive results for S-110 protein, HMB 45 and melan A.[8]
Treatment
Surgery represents the primary treatment modality. Chemotherapy may be ineffective, but checkpoint inhibitors and BRAF and MEK inhibitors have been recently tested in vaginal melanomas.[8]
References
- ^ "Vulva and Vagina tumors: an overview". atlasgeneticsoncology.org.
- ^ a b c d Wohlmuth C, Wohlmuth-Wieser I, May T, Vicus D, Gien LT, Laframboise S (2019-11-29). "Malignant Melanoma of the Vulva and Vagina: A US Population-Based Study of 1863 Patients". American Journal of Clinical Dermatology. doi:10.1007/s40257-019-00487-x. ISSN 1179-1888. PMID 31784896.
- ^ a b Kalampokas E, Kalampokas T, Damaskos C (January 2017). "Primary Vaginal Melanoma, A Rare and Aggressive Entity. A Case Report and Review of the Literature". In Vivo. 31 (1): 133–139. doi:10.21873/invivo.11036. PMC 5354139. PMID 28064232.
- ^ Chen L, Xiong Y, Wang H, Liang L, Shang H, Yan X (October 2014). "Malignant melanoma of the vagina: A case report and review of the literature". Oncology Letters. 8 (4): 1585–1588. doi:10.3892/ol.2014.2357. PMC 4156219. PMID 25202372.
- ^ "Vaginal Cancer Treatment". National Cancer Institute. 1980-01-01. Retrieved 2018-02-08.
- ^ "About DES". Centers for Disease Control and Prevention. Retrieved February 8, 2018.
- ^ "Known Health Effects for DES Daughters". Centers for Disease Control and Prevention. Retrieved February 8, 2018.
- ^ a b Wohlmuth C, Wohlmuth-Wieser I (December 2019). "Vulvar malignancies: an interdisciplinary perspective". J Dtsch Dermatol Ges. 17 (12): 1257–1276. doi:10.1111/ddg.13995. PMC 6972795. PMID 31829526.
External links
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