7/13/2023 0 Comments Picture of hymenal tag![]() ![]() Most of the cases are seen in the lower one-third of the anterior vaginal wall. Vaginal melanomas usually present in the fifth to seventh decades of life. 3 Little is known about the risk factors, etiological factors, and the pathogenesis of these tumors. The aforesaid melanocytes beget primary malignant melanoma of the vagina. Melanocytes are seen as embryological remnants of neural crest cells in three percent of healthy women. Around 85% of cases arise in the labia minora, clitoris, or inner side of the labia majora. 1 The most common site for gynecologic melanomas is the vulva. The first case of malignant melanoma of the female genital tract was reported by Hewitt in 1861. The melanomas occurring in the female genital tract are biologically aggressive and account for 3% to 7% of all melanomas. The lower extremities are the commonest site in women. Melanoma is a malignancy that most commonly arises in the sun-exposed regions of the trunk and extremities. The clue to diagnosis came from a hymenal mucosal tag specimen of the same patient which showed classical features of malignant melanoma. Here we present a case report and literature review of a case of primary vaginal malignant melanoma, the morphology of which mimicked an undifferentiated pleomorphic sarcoma. 3, 4, 5 The unusual phenotypic profiles of melanomas, including those that mimic the non- melanocytic lineage, may pose a diagnostic challenge. Most of the cases are pigmented while a few are amelanotic. Macroscopically most are polypoidal or nodular, with an average size of 2-3 cms. The tumour mass is usually located in the anterior and lateral walls of the lower third of the vaginal wall. The most common symptom is vaginal bleeding followed by vaginal mass and discharge. 1, 2 Most of the patients are post-menopausal with a mean age of around 60 years. It accounts for less than 0.3% of all melanomas and approximately 4% of vaginal malignancies. Primary malignant melanoma of the vagina is a rare and aggressive malignancy with a high risk of local recurrence and distant metastasis. ![]()
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