OBJECTIVE

To analyze the clinical characteristics, diagnosis, treatment and prognosis of primary malignant melanoma in female genital tract.

METHODS

The clinical data of 42 patients of primary malignant melanoma in female genital tract were reviewed.

RESULTS

The tumors were originated from vulva, vagina and cervix in 14 (33%), 23 (55%) and 5 (12%) cases, respectively. Thirty-eight cases had biopsies. Among them, 6 cases were misdiagnosed. Eighteen surgical specimens were examined by immunohistochemistry assays. S-100 protein was positive in all cases, and monoclonal antibody to melanoma of human (HMB-45) was positive in 14 cases. The 2-year and 5-year cumulative recurrence-free survival rates were 35% and 23% respectively, while the 2-year and 5-year cumulative overall survival rates were 53% and 27% respectively. The 2-year cumulative overall survival rates for the patients of early stage [International Federation of Gynecology and Obstetrics (FIGO) stage I and II] and that of advanced stage (stage III and IV) were 77% and 34% respectively (P < 0.05). The 2-year cumulative overall survival rates for the patients of stage I and stage II were 78% and 74% respectively (P = 0.303). In the 40 patients who received surgery, univariate analysis showed that the adjuvant chemotherapy improved the recurrence-free survival and the overall survival significantly (P < 0.05), and the other factors including radical surgery, regional lymphadenectomy, biotherapy and radiotherapy did not affect prognosis (P > 0.05). Compared with chemotherapy, biochemotherapy did not improve prognosis significantly (P > 0.05).

CONCLUSIONS

Biopsy for the malignant melanoma in female genital tract has high misdiagnosis rate. Immunohistochemistry assay could improve diagnosis markedly. The FIGO staging system fails to predict the prognosis accurately. Surgery plays an important role in treatment, while the adjuvant chemotherapy could improve survival effectively.