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.