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Case Report
1 Department of Gynecology and Obstetrics, Kantonsspital Luzern, Spitalstrasse, 6000 Luzern 16, Switzerland
Address correspondence to:
Barbara Kipp
Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Kantonsspital Luzern, Spitalstrasse, 6000 Luzern 16,
Switzerland
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Article ID: 100061Z08BK2020
Introduction: A primary malignant melanoma of the vagina (PMMV) is a rare and aggressive disease. At the time of diagnosis the tumors are mostly already large in size thus entailing a high risk for local recurrence and distant metastasis. Various treatment regimens such as local wide excision, radical surgical procedures, and nonsurgical treatment (primary radiotherapy, chemotherapy, and immunotherapy) have been described in literature. A standard treatment protocol has not yet been defined.
Case Report: We present an 89-year-old woman with abnormal vaginal bleeding, resulting in a malignant melanoma of the vagina. The tumor size revealed in magnetic resonance imaging (MRI) scan was 6.6 × 3.2 cm with close localization to the rectal wall. We recommended radical surgery to achieve free margins which she refused. Despite good local response after primary radiotherapy she died six months later because of distant metastasis.
Conclusion: In PMMV primary radiotherapy is a valuable treatment option whenever surgery is not feasible or refused by the patient. As we described in our case local control is achievable but the life limiting risk of distant metastasis remains. Further investigation to define a standard treatment protocol is needed.
Keywords: Malignant melanoma, Primary radiotherapy, Standard of treatment, Vagina
Barbara Kipp - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Corina Christmann - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 Barbara Kipp et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.