Wang Dongying, Xu Tianmin, Zhu He, Dong Junxue, Fu Li
Department of Obstetrics and Gynecology, Second Hospital of Jilin University Changchun, Jilin, P. R. China.
Department of Molecular Biology, Max Planck Institute for Infection Biology Berlin, Germany.
Am J Cancer Res. 2020 Dec 1;10(12):4017-4037. eCollection 2020.
The female lower genital tract melanomas mainly include vulvar, vaginal and cervical melanoma. There is little clinical data on the melanomas thus making them highly lethal with their prognosis being worse than for cutaneous melanoma and other gynecological malignancies. Surgery is still the primary treatment for gynecological melanomas with wide local resection (WLE) of tumors with adequate margins being preferred for early-stage vulvar melanoma while complete resection of the primary tumor is the standard treatment for early-stage cervical and vaginal melanoma. Sentinel lymph node biopsy seems to avoid unnecessary complete regional lymphadenectomy. However, it should be chosen cautiously. Recently discovered molecular changes have provided new hopes for effective systemic treatment of female genital tract melanomas. In this review, we summarize the pathogenesis and clinicopathological characteristics of these rare melanomas with particular emphasis on new therapies and clinical management methods that may affect prognosis. The review aims to provide a viable direction for clinicians to diagnose and treat female lower genital tract melanomas.
女性下生殖道黑色素瘤主要包括外阴、阴道和宫颈黑色素瘤。关于这些黑色素瘤的临床数据很少，因此它们具有高度致死性，其预后比皮肤黑色素瘤和其他妇科恶性肿瘤更差。手术仍然是妇科黑色素瘤的主要治疗方法，早期外阴黑色素瘤首选对肿瘤进行广泛局部切除（WLE）且切缘足够，而对于早期宫颈和阴道黑色素瘤，完整切除原发肿瘤是标准治疗方法。前哨淋巴结活检似乎可避免不必要的完全区域淋巴结清扫术。然而，应谨慎选择。最近发现的分子变化为女性生殖道黑色素瘤的有效全身治疗带来了新希望。在本综述中，我们总结了这些罕见黑色素瘤的发病机制和临床病理特征，特别强调了可能影响预后的新疗法和临床管理方法。本综述旨在为临床医生诊断和治疗女性下生殖道黑色素瘤提供可行的方向。
