title: Management of melanomas of the gynaecological tract.
abstract: OBJECTIVE
  Primary melanomas originating from the gynaecological tract are rare and aggressive cancers. The 5-year survival is around 10%. The majority of tumours differ from cutaneous melanomas, which arise from the skin, by developing from melanocytes located in mucosal epithelium. The clinical behaviour, prognosis and the biology of mucosal melanomas are distinct from cutaneous melanomas. In this article, we summarize the current management of melanomas of the gynaecological tract (vulva, vagina, ovary and cervix) and discuss the progress in developing new treatments.
  
  
  RESULTS
  The management of mucosal melanomas has not changed substantially over the last decade and the prognosis remains poor. Surgery remains the primary treatment of choice in all localized melanomas of the genital tract. Radiotherapy and chemotherapy are options but have limited success for the majority of women. Activation of c-KIT occurs in vulvar melanomas. Clinical trials of targeted agents are underway.
  
  
  CONCLUSIONS
  As a result of the rarity of gynaecological tract melanomas, challenges associated with their anatomical locations and resistance to conventional radiotherapy and chemotherapy, this group of conditions remain difficult to treat and continue to have a poor prognosis. A greater understanding of the molecular profile of these cancers may provide promising targeted approaches.
authors.affiliation: aGynaecological Unit bMelanoma Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom.
authors.forename: Marielle A E
authors.initials: MA
authors.lastname: Nobbenhuis
authors.forename: Susan
authors.initials: S
authors.lastname: Lalondrelle
authors.forename: James
authors.initials: J
authors.lastname: Larkin
authors.forename: Susana
authors.initials: S
authors.lastname: Banerjee
mesh_terms: D005260:Female; D005833:Genital Neoplasms, Female / Q000628:therapy*; D006801:Humans; D008545:Melanoma / Q000628:therapy*