title: Vaginal fistula in a patient with relapsed ovarian cancer and amelanotic melanoma.
abstract: BACKGROUND
  Malignant vaginal melanoma is extremely rare and accounts for fewer than 0.3% of all melanomas in women. Amelanotic malignant melanoma is a subtype of melanoma with little or no pigment on visual inspection. The simultaneous occurrence of amelanotic melanoma of the vagina and serous ovarian cancer is extremely rare.
  
  
  METHODS
  A 61-year-old patient was referred to our hospital with recurrent ovarian cancer in association with a vaginorectal fistula. The first diagnosis was performed in 2009. The patient underwent multi-ovarian cancer recurrences after the primary cytoreductive surgery, especially in the vaginal vault, with several different lines of chemotherapy. The pathological results on this occasion demonstrated recurrent ovarian cancer with a component of amelanotic melanoma in the region of a vaginorectal fistula.
  
  
  CONCLUSIONS
  We recommend detailed immunohistochemical staining, especially for recurrent ovarian cancer in combination with abnormal localizations or manifestations, in order to reveal any associations with another tumor.
authors.affiliation: Department of Gynecology and Gynecological Oncology. Charité/Campus Virchow-Klinikum, University Medicine of Berlin, Berlin, Germany. Mustafa-Zelal.Muallem@charite.de
authors.forename: Mustafa Zelal
authors.initials: MZ
authors.lastname: Muallem
authors.forename: Sule
authors.initials: S
authors.lastname: Yildiz
authors.forename: Ruza
authors.initials: R
authors.lastname: Arsenic
authors.forename: Uwe
authors.initials: U
authors.lastname: Trefzer
authors.forename: Jalid
authors.initials: J
authors.lastname: Sehouli
mesh_terms: D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D018328:Melanoma, Amelanotic / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D009154:Mutation; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000628:therapy; D009375:Neoplasms, Glandular and Epithelial / Q000473:pathology* / Q000628:therapy; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000628:therapy; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D014624:Vaginal Fistula / Q000209:etiology*; D014625:Vaginal Neoplasms / Q000473:pathology* / Q000628:therapy
chemical_list: C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf