ABSTRACT
Only a few examples of vaginal melanoma have been documented in the
literature, making it an unusual change. Patients frequently present
with vaginal bleeding, discharge, or a lump that may be felt.
Post-menopausal Caucasian women between the ages of 60 and 80 are most
commonly affected. The prognosis for vaginal melanomas is worse because
the diagnosis is made when the condition is further advanced. This case
involves a 54-year-old woman who visited the clinic complaining of
foetid tranvaginal haemorrhage. The diagnosis of aggressive melanoma
with AJCC stage IV was made based on the biopsy results. The patient
declined drastic surgery due to her advanced age and the severity of her
cancer, so postoperative radiation and conservative surgery were used
instead. Nivolumab and ipilimumab immunotherapy was subsequently used.
KEYWORDS: Foetid Transvaginal Haemorrhage, Immunotherapy,
Postmenopausal Women, Vaginal Melanoma,
INTRODUCTION
It is believed that melanocytic cells found in the skin and mucosal
membranes are where malignant melanoma cells develop. Primary malignant
melanoma of the vagina is a rare tumour that has a short survival period
and a significant risk of recurrence. even though the first mention of
it was in 1887 [1]. Few than 250–300 cases have been documented in
the literature, or just 0.46 cases per million women annually [2].
Malignant melanoma makes up 3-5% of all vulvar malignancies and 10% of
all female genital tract melanomas and for 0.3–0.8% of all malignant
melanomas [2]. Primary malignant melanoma of the vagina typically
affects postmenopausal women aged 60 to 80 (average age is 68)]
[3,4]. Vaginal discharge, vaginal bleeding, the development of
widespread, irregular, occasionally mottled macular hyperpigmentation,
or a palpable mass, are the most typical symptoms of this tumour.
Despite treatment, 5-year survival rates for melanoma of the vagina have
been reported to be less than 30% due to the disease’s markedly greater
aggressiveness compared to its cutaneous counterparts [6]. The case
of vaginal melanoma is described in the current article, along with a
review of the available treatments.