#439 Primary malignant melanoma of the female genital tract: clinical characteristics and management

Introduction/Background

Malignant melanoma of the genital tract comprises 3% of all melanomas afflicting females. The most frequent location of melanoma in the female genital tract is the vulva, whereas the vagina is seldom affected, and is most frequently diagnosed at an advanced stage, resulting in early recurrence and a poor prognosis. Because of their rarity, there are currently no established guidelines for the treatment of genital melanomas. This present study describes the symptoms, management, and prognosis of women attending at National Institute of Cancer Research and Hospital, Bangladesh with malignant melanoma of the vulva, vagina, and cervix.

Methodology

A 5 year (2016–2021) observational study was conducted in department of Gynaecological Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh. Data were collected from hospital record book retrospectively.

Results

Six women with genital melanoma were attended within the study period, mean age: 54.67 years, minimum age: 48years and maximum age: 70 years, most of the women are post-menopausal. Vagnial discharge was the commonest presenting symptom, 2 cases with vaginal melanoma, 3 cases with vulval melanoma and one cervical melanoma, presented in advanced stage (50% in stage II, 50% in stage III). Almost all patients received surgical treatment with radiation and chemotherapy as adjuvant. External beam radiotherapy (EBRT) and chemotherapy combination with (cisplatin, vinblastine and decarbazin) was given. Average DFS was 9.16 months.

Conclusion

The occult nature of their anatomical location contributes to the late presentation and late diagnosis. Because of their rarity, there are currently no established guidelines for the treatment of genital melanomas. Complete resection may be difficult due to their anatomical location, and often resistant to chemotherapy and radiotherapy.

Disclosures

No conflict of interest.