title: Metastatic melanoma to the vagina: clinicopathologic and immunohistochemical study of three cases and literature review.
abstract: We report the clinicopathologic features of three cases of malignant melanoma metastatic to the vagina; only one similar case has been previously reported. The age of the patients ranged from 33 to 70 years; two presented with vaginal bleeding. Two patients had a history of a previous primary malignant melanoma, one a preauricular melanoma treated 7 years earlier and the other a vulvar melanoma treated 2 years earlier. In the third case, a primary malignant melanoma was found on the sole of the right foot after the patient had presented with the vaginal metastases. On gross examination, the vaginal tumors were polypoid; two were on the posterior wall and one was on the anterior wall. All were of epithelioid cell type and were positive with S-100 and microphthalmia-transcription factor. Tyrosinase was positive in two cases, HMB-45 was positive in one case, and MART-1 was focally positive in one case. One patient underwent wide local excision of tumor followed by chemotherapy, one patient had intracavitary radiotherapy, and one had palliative radiotherapy to the brain only. The patients died after a follow-up of 3, 14, and 48 months.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas-Houston Health Science Center, Houston, Texas, USA.
authors.forename: Deepali
authors.initials: D
authors.lastname: Gupta
authors.forename: Antonio G
authors.initials: AG
authors.lastname: Neto
authors.forename: Michael T
authors.initials: MT
authors.lastname: Deavers
authors.forename: Elvio G
authors.initials: EG
authors.lastname: Silva
authors.forename: Anais
authors.initials: A
authors.lastname: Malpica
mesh_terms: D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor / Q000032:analysis*; D004268:DNA-Binding Proteins / Q000378:metabolism; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D058965:MART-1 Antigen; D008545:Melanoma / Q000556:secondary*; D058950:Melanoma-Specific Antigens; D051739:Microphthalmia-Associated Transcription Factor; D014442:Monophenol Monooxygenase / Q000378:metabolism; D009363:Neoplasm Proteins / Q000378:metabolism; D012189:Retrospective Studies; D009418:S100 Proteins / Q000378:metabolism; D012878:Skin Neoplasms / Q000473:pathology*; D014157:Transcription Factors / Q000378:metabolism; D014625:Vaginal Neoplasms / Q000556:secondary*
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; D058965:MART-1 Antigen; C497234:MITF protein, human; C548667:MLANA protein, human; D058950:Melanoma-Specific Antigens; D051739:Microphthalmia-Associated Transcription Factor; D009363:Neoplasm Proteins; D009418:S100 Proteins; D014157:Transcription Factors; D014442:Monophenol Monooxygenase