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Summary
Malignant melanoma (MM) arising primarily in the cervix is exceedingly rare and has a poor prognosis. We report the case of a primary MM of the cervix in a 64-year-old woman with vaginal bleeding. She presented with a cervical amelanotic lesion which on biopsy rendered the diagnosis of MM. The patient was staged as International Federation of Gynecology and Obstetrics IIB and underwent Wertheim-Meigshysterectomy followed by brachytherapy. One year later, she was diagnosed with a large pelvic relapse for which surgery was performed. She then presented with a vaginal relapse and an isolated hepatic lesion, both of which were proposed for surgery. The diagnosis of MM of the cervix is a clinical and pathological challenge due to its rarity and overlapping features. Cytology cannot accurately diagnose it. Moreover, amelanotic MMs must be distinguished from other poorly differentiated carcinomas by diagnosis that ultimately relies on immunohistochemical staining. Radical surgery is the only treatment showing predictive benefit.
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Footnotes
Contributors All authors made a substantial contribution for the writing of this case report, namely: IJ
was the main responsible for the conception and planning of this case report. He substantially reviewed available literature, started and accomplished the report draft, compiled available data, and interpreted and discussed important data integrating it with current literature. He comprehensively and critically reviewed the final draft, ensuring the truth and integrity of all the information. SDC
actively contributed for the acquisition and interpretation of data, namely regarding pathology, and helped writing the final draft. She was also responsible for reviewing the literature and appraisal of scientific contents. She acquired some of the figures proposed for publishing and interpreted them, integrating all available data with their information. She comprehensively and critically reviewed the final draft, ensuring the truth and integrity of all the information.
VP is one of the gynecologists of the department responsible for the reported treatment. She helped from the beginning with the conception and design of the report and critically adjusted the gynaecological information and integrated it with the remaining data. She helped acquiring and building the rationale behind this report and participated in the discussion of this case among the other authors before translating it into this draft. She comprehensively and critically reviewed the final draft, ensuring the truth and integrity of all the information. AR
was responsible for coordinating the work and structuring it into the final report. She analysed all data, critically evaluated the scenarios and revised the final draft. She conducted major changes in the structure of the initial design helping the group of authors to better organise the information. She comprehensively and critically reviewed the final draft, ensuring the truth and integrity of all the information.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.