Shrestha Ramesh, Devkota Karun, Thapa Baburam Dixit, Dahal Mona, Silwal Sudhir Raj, Dulal Soniya, Regmi Mohan Chandra, Ortiz Beverly Hannah
Department of Obstetrics and Gynaecology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Department of Radiology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Gynecol Oncol Rep. 2023 May 26;47:101206. doi: 10.1016/j.gore.2023.101206. eCollection 2023 Jun.
Primary vulvar melanoma is a rare but highly aggressive malignant neoplasm accounting for 1-2 % of all malignant melanoma and 5-10 % of all vulvar cancers in females. Here we report a case of 32 years old female diagnosed with primary vulvar melanoma during the evaluation of a two cm growth in the inner labia minora on the right side. She underwent wide local excision with excision of the distal one cm of the urethra and bilateral groin node dissection. The final histopathology was vulvar malignant melanoma with 1 out of 15 groin nodes involved but all resected margins were free of tumor. The final surgical stage was T4bN1aM0 (8th AJCC TNM) and IIIC (FIGO). She received adjuvant radiotherapy followed by 17 cycles of Pembrolizumab. To date, she is both clinically and radiologically disease free with a progression-free survival of 9 months.
原发性外阴黑色素瘤是一种罕见但侵袭性很强的恶性肿瘤，占所有恶性黑色素瘤的1%-2%，占女性所有外阴癌的5%-10%。在此，我们报告一例32岁女性病例，该患者在评估右侧小阴唇内侧一个2厘米的肿物时被诊断为原发性外阴黑色素瘤。她接受了广泛局部切除，切除了尿道远端1厘米，并进行了双侧腹股沟淋巴结清扫。最终组织病理学检查结果为外阴恶性黑色素瘤，15个腹股沟淋巴结中有1个受累，但所有切除边缘均无肿瘤。最终手术分期为T4bN1aM0（第8版美国癌症联合委员会TNM分期）和IIIC期（国际妇产科联盟分期）。她接受了辅助放疗，随后进行了17个周期的帕博利珠单抗治疗。迄今为止，她在临床和影像学上均无疾病，无进展生存期为9个月。
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