Malignant melanoma of the female genital tract. A report of nine cases in the Chinese of Hong Kong.

Ten cases of malignant melanoma of the female genital tract were diagnosed in Chinese patients in Hong Kong over the 12 yr period from 1978 to 1990. Of the 9 cases considered here, 4 involved the vagina alone, 2 the vagina and cervix, 2 the uterine cervix alone, and 1 occurred on the vulva. Thus, contrary to the usual reported distribution, the vulva was an uncommon site. While the mean age of the patients was 58 yrs, 2 patients were in their thirties and both had a history of a recent pregnancy. Vaginal bleeding or discharge were the presenting symptoms in most cases. The primary origin was confirmed histologically in 6 of the 9 cases and all were of the mucosal lentiginous type. Deep invasion, beyond 3 mm, was present in all cases at the time of diagnosis. Five patients died of the disease 2-22 months after diagnosis. The 4 surviving patients were clinical Stage I and II (FIGO) when diagnosed and have a median survival of 18 months to date. Both the FIGO clinical stage and Breslow's tumor thickness proved to be good prognostic indicators.