Primary malignant melanoma of the uterine cervix: case report and review of the literature.
Objective: To present a case of malignant melanoma of the uterine cervix and review the medical literature, evaluate the clinical presentations and prognosis, and establish a plan of management for this rare pathology.Methods: A case of cervical malignant melanoma treated at our institution was prospectively followed until her death. An extensive MEDLINE search was then performed to obtain all previous case reports on this entity. Information regarding age, clinical presentation, staging, pathology, lymphnode status, treatment, and survival was reviewed.Results: Our patient is a 70-year old white female who presented with a 4-month history of irregular vaginal bleeding. She was diagnosed with malignant melanoma of the cervix, stage IIa, for which she underwent a modified radical hysterectomy, partial vaginectomy, and pelvic and para-aortic lymph node dissection. She received adjuvant radiation therapy to the pelvis, total dose of 4500 cGy. The patient's survival was 29 months. There have been only 24 published cases of primary cervical melanoma in the medical literature. The patients' ages ranged from 39 to 78 years old. The main presenting symptom was vaginal bleeding (67%). The majority of the patients, 58%, presented in early stages (Ia to IIa). Treatment was varied, ranging from a simple excision of a mass to radical hysterectomy with lymph node dissection and adjuvant radiation or chemotherapy. Survival was widespread, even within the same stage.Conclusion: Cervical melanoma is a rare disease of which no prospective or retrospective studies exist, only case reports. Treatment controversies exist. We recommend radical surgical excision to obtain negative margins and lymphadenectomy only for grossly positive nodes. The prognosis is poor and unpredictable.
Cantuaria
G
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Miami, Florida, Miami, USA
Angioli
R
Fernandez-Abril
A
Penalver
M