CONCLUSION
The least common gynaecological neoplasia, primary vaginal melanoma has
an aggressive evolution and a bad prognosis since it has a marked
tendency to produce metastases. For these reasons, it is typically
detected at an advanced stage. It is advised to perform a biopsy and an
immunohistochemistry study of any lesions suspected of being cancerous
when a hyperpigmented tumour is found during a gynaecological
examination as this is suggestive of vaginal melanoma. Being so unusual,
there are no standardised recommendations for the therapy. The current
main therapy strategy appears to be surgery followed by postoperative
radiation. In the instance of our patient, no tumour regression or
metastasis was seen despite cautious surgical resection, postoperative
radiotherapy, and 5 rounds of immunotherapy, however the patient was
still alive after 2 years after diagnosis. It takes a multidisciplinary
effort involving gynaecologists, pathologists, dermatologists, and
surgeons to have a standardised diagnostic and therapeutic approach to
this pathology as early diagnosis is currently the only way to modify
the prognosis of this neoplasm.