자궁경부 및 질에 발생한 악성 흑색종의 1 예

Abstract

Malignant melanoma of the female genital tract comprises 3% of all melanomas afflicting females. The majority of these genital tract lesions arise in the vulva and very seldom in the ovary, uterus, and uterine cervix. The history, mode of presentation, and treatment of this neoplasm has been discussed. The tumor seems to arise from melanocytes that are usually present in the cervix and vagina. Vaginal bleeding was the most common complaint. Histochemical (Fontana-Masson silver stain) and immunohistochemical (Vimentin, S-100 protein, HMB-45 antibody), procedures confirm the initial diagnosis. Although there has been no consensus as to comprehensive treatment, radical abdominal hysterectomy with bilateral salpingo-oophorectomy is generally advocated. Although malignant melanoma is usually classified as a radioresistant tumor, reports show that local excision combined with high-dose irradiation is effective in treating primary disease. Also, radiation can be used as adjuvant or palliative treatment but its efficacy has not been well established. Systemic chemotherapy would be the theoretical best therapy. Unfortunately, effective chemotherapy with tolerable side effects is not presently available. Prognosis for this entity is poor. This article reports one new case and reviews the literature of primary malignant cervical and vaginal melanoma.