Primary Malignant Melanoma of the Vagina in Bangladesh: Report of a Case Series and Review of the Literature

Abstract

Objective: This study describes the characteristics of patients with primary malignant melanoma of the vagina and their treatment at National Institute of Cancer Research and Hospital in Dhaka, Bangladesh, from February 2013-January 2015. Materials/Methods: Eight patients with primary malignant melanoma of the vagina were identified. Medical records were reviewed for demographic information, treatment, and outcomes. This investigation was approved by the Ethics Committee of the National Institute of Cancer Research and Hospital. Results: The median age was 48 years (range: 35 - 65 years) and most patients were premenopausal. Seven of the eight patients presented with International Federation of Gynecology and Obstetrics (FIGO) stage II. The five patients had disease confined mainly to the upper and middle thirds of the vagina. One patient was diagnosed with stage IV disease. In two patients, cervical metastases were present. Almost all patients received radiotherapy. Two patients with stage II disease developed local recurrences within eighteen months. The one patient with stage IV disease died ten months after diagnosis. Conclusion: Primary malignant melanomas of the vagina are uncommon, highly aggressive tumors that are associated with poor overall survival. Surgery is the mainstay of treatment. Nearly 80% of vaginal melanomas will recur. Overall 5-year survival ranges from 5% to 25%. The size of the tumor (>than 3 cm) and the presence of lymphadenopathy at diagnosis worsen the overall survival.