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Background: Primary malignant melanoma of the vagina is an aggressive and very rare malignancy. This tumor constitutes less than 3% of vaginal cancers and only 0.3-0.8% of all melanomas in women. The overall prognosis for patients with vaginal melanoma is poor. Furthermore, once a recurrence is noted, survival is extremely poor, with a mean survival time of 8.5 months. The result of bibliographic search for recurrent vaginal melanoma, only 3 cases have been reported to survive 5 years after re-treatment for recurrence. We report a case of vaginal melanoma with a survival of longer than 5 years after recurrence.
Case: A 38-year-old woman presented with amelanotic melanoma of the vagina and underwent an operation and adjuvant chemotherapy. Twenty months later, sacral lymph node metastasis was observed. We removed her metastatic foci by surgery, and 2 of 15 lymph nodes demonstrated metastasis of malignant melanoma. The patient underwent 5 courses of adjuvant chemotherapy. She is alive and without evidence of disease 141 months after recurrence.
Conclusion: While the prognosis of vaginal melanoma is poor, in certain cases, early detection and early treatment may improve the prognosis.