title: Mucosal melanoma of the female genital tract is a multifocal disorder.
abstract: OBJECTIVE
  This is a retrospective analysis of malignant melanoma of the female genital tract, focusing on the high local recurrence rate of this tumor.
  
  
  METHODS
  All women treated for malignant melanoma of the genital tract were identified through the archives of the Hadassah University Hospital. The medical records and the pathological specimens were reviewed and reevaluated.
  
  
  RESULTS
  From 1986 to 2002, nine cases were diagnosed and treated at Hadassah. Seven had vulvar melanoma and two had vaginal melanoma. Sixty-six percent (6/9) of the patients had more than one focus of melanoma, either apparent at their initial diagnosis (3/9) or developed during follow up (3/9). Most of the recurring lesions were melanoma in situ. In one patient multiple nodular melanomas were detected. Atypical melanocytic hyperplasia was found in an otherwise normal mucosa in four patients. Three had experienced multiple recurrences. All patients were treated by radical local excisions with (3/9) or without (6/9) elective groin lymph node dissection. Three patients with locally recurring melanoma within the genital tract required two to five sessions of repeated surgical excisions.
  
  
  CONCLUSIONS
  It is suggested that melanoma of the genital tract is the result of a multifocal disorder of the melanocytes within the mucosa. The increased local recurrence rate reflects an inherent abnormality of melanocytes. It is not attributed to surgical failure in controlling the disease. Insistent and even radical surgical excision is recommended, especially for patients whose prospects for prolonged survival are improved.
authors.affiliation: Sharett Institute of Oncology, Hadassan University Hospital, Jerusalem 91120, Israel. lotem@isdn.net.il
authors.forename: Michal
authors.initials: M
authors.lastname: Lotem
authors.forename: Saul
authors.initials: S
authors.lastname: Anteby
authors.forename: Tamar
authors.initials: T
authors.lastname: Peretz
authors.forename: Arieh
authors.initials: A
authors.lastname: Ingber
authors.forename: Ilana
authors.initials: I
authors.lastname: Avinoach
authors.forename: Diana
authors.initials: D
authors.lastname: Prus
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000473:pathology*; D012189:Retrospective Studies; D014625:Vaginal Neoplasms / Q000473:pathology*; D014846:Vulvar Neoplasms / Q000473:pathology*