Treatment of recurrent vaginal melanoma with external beam radiation therapy and palladium-103 brachytherapy.
BACKGROUND
Mucosal melanoma of the female genital tract that recurs locally after definitive surgery presents difficult challenges for salvage therapy.


METHODS
A 71-year-old female was diagnosed with a 4.5-cm x 4.1-cm x 2.8-cm vaginal recurrence of genital tract mucosal melanoma after definitive vulvectomy, distal vaginectomy, and distal urethrectomy. She refused surgery and underwent combination external beam radiation therapy (46 Gy) and an ultrasound-guided palladium-103 brachytherapy implant (100 Gy).


RESULTS
The patient experienced complete resolution of the gross tumor and was asymptomatic with a sustained response for over a year before developing metastatic disease.


CONCLUSIONS
Mucosal melanoma of the female genital tract is an aggressive and often fatal disease. Radical surgical excision is an option for some patients but may require pelvic exenteration and is rarely curative. In selected cases, high-dose conformal radiation therapy delivered by a combination of external beam radiation therapy and interstitial brachytherapy may be an excellent alternative, achieving local control without loss of organ function.
McGuire
Sean E
SE
Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Frank
Steven J
SJ
Eifel
Patricia J
PJ
D000368:Aged; D001918:Brachytherapy; D005260:Female; D006801:Humans; D008545:Melanoma / Q000532:radiotherapy*; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D010165:Palladium / Q000008:administration & dosage*; D011868:Radioisotopes / Q000008:administration & dosage*; D014625:Vaginal Neoplasms / Q000532:radiotherapy*
D011868:Radioisotopes; D010165:Palladium