Clinical analysis of primary malignant melanoma of the cervix.
OBJECTIVE
To investigate the clinical and pathological characteristics of primary cervical malignant melanoma, and its prognosis.


METHODS
The clinical and pathological data of four patients with primary malignant melanoma of the cervix were analyzed retrospectively. Nerve tissue protein S-100 and monoclonal antibody to melanoma (HMB-45) were measured in all cases by immunohistochemical method. All four patients received radical hysterectomy. Three of them received chemotherapy preoperation or postoperation, and one of them received biotherapy with interferon-gamma and interleukin-2 at the same time. All the cases were followed up.


RESULTS
The average age of four patients was 45 years. Clinical symptoms presented with irregular vaginal bleeding, postcoital bleeding, or increase of vaginal discharge. Gynecologic examination showed polypus papilla cauliflower-shaped or nodulated black-brown or black-blue mass on the cervix. All the four cases were pathologically diagnosed with cervical malignant melanoma. S-100 and HMB-45 were positive in all patients. Two patients died at 6 and 41 months postoperation, respectively. The other two patients survived for 3.5 and 7 years postoperation, respectively.


CONCLUSIONS
S-100 protein and HMB-45 play very important roles in the diagnosis of primary malignant melanoma of cervix. Radical hysterectomy, chemotherapy combined with dimethyl triazemo imidazole carboxamide and biological therapies may improve the prognosis of the primary malignant melanoma of cervix if the disease could be diagnosed in an early stage.
Ma
Shui-qing
SQ
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730. mashuiqing1964@yahoo.com.cn
Bai
Chun-mei
CM
Zhong
Sen
S
Yu
Xiao-hong
XH
Lang
Jing-he
JH
D000328:Adult; D000911:Antibodies, Monoclonal / Q000378:metabolism; D017024:Chemotherapy, Adjuvant; D003606:Dacarbazine / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D007371:Interferon-gamma / Q000627:therapeutic use; D008545:Melanoma / Q000276:immunology / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D009418:S100 Proteins / Q000378:metabolism; D002583:Uterine Cervical Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy
D000911:Antibodies, Monoclonal; D009418:S100 Proteins; D003606:Dacarbazine; D007371:Interferon-gamma