(2023). Primary Vaginal Melanoma: A Rare and Aggressive Entity, A Radical Hystero-Vaginectomy as a Compromise Treatment Option. test, 93(1), 7716-7722. doi: 10.21608/ejhm.2023.329204
. "Primary Vaginal Melanoma: A Rare and Aggressive Entity, A Radical Hystero-Vaginectomy as a Compromise Treatment Option". test, 93, 1, 2023, 7716-7722. doi: 10.21608/ejhm.2023.329204
(2023). 'Primary Vaginal Melanoma: A Rare and Aggressive Entity, A Radical Hystero-Vaginectomy as a Compromise Treatment Option', test, 93(1), pp. 7716-7722. doi: 10.21608/ejhm.2023.329204
Primary Vaginal Melanoma: A Rare and Aggressive Entity, A Radical Hystero-Vaginectomy as a Compromise Treatment Option. test, 2023; 93(1): 7716-7722. doi: 10.21608/ejhm.2023.329204

Primary Vaginal Melanoma: A Rare and Aggressive Entity, A Radical Hystero-Vaginectomy as a Compromise Treatment Option

The Egyptian Journal of Hospital Medicine
Article 122, Volume 93, Issue 1, October 2023, Pages 7716-7722    PDF (333.53 K)
DOI: 10.21608/ejhm.2023.329204
Abstract
Background: The greatest outcomes of primary vaginal melanoma have been associated with surgery, either alone or in combination with adjuvant therapy, making it the preferred course of treatment for primary malignant vaginal melanoma.
Objectives: We suggest describing the radical hystero-vaginectomy approach as a compromise between pelvic exenteration operations and conservative excision.
Material and Methods: This study was carried out in National Cancer Institute and El Galaa Maternity Teaching Hospital through the period from January 2018 and January 2022. The study included 8 cases with different ages and different complaints, sharing the same diagnosis of primary vaginal melanoma. They had different surgical approaches; conservative (4 cases) or radical surgeries (4 cases) with different results. The surgical outcomes were analyzed and determining of surgical technique was described.
Results: The mean age of our patients was 50.6 years. The most common initial complaint was abnormal vaginal bleeding (6 patients), The most common site of lesion was left lateral wall (5 patients) and posterior wall (5 patients) of vagina. The depth of invasion was greater than 1 cm in only one patient but unrecorded in 7 patients. The clinical and surgical staging of the disease according to the international federation of gynecology and obstetrics (FIGO) varied between two and three. One case staged as PT4 melanoma according to the tumor node and metastases (TMN) staging due to extra margin related to anterior rectal wall was positive. Recurrence in patients underwent local excision ranged from 5 months to 15 months after surgical excision. The 2-year DFS (disease free survival) comparing the radical and the conservative treatment was 75 % versus 0 %. Conclusions: Upon initial diagnosis, surgery continues to be the primary therapeutic option. For vaginal melanomas, local excision is challenging and frequently not taken into consideration. We reported a radical hystero-vaginectomy as a compromise treatment option for primary vaginal melanoma that can take the place of the pelvic exenteration operation.
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