Gao Yunge, Dong Jian, Chen Ligang, Guo Xin, Liu Lingling, Guo Weinan, Ma Cuiling, Chen Biliang, Wang Jian, Lv Xiaohui
Department of Obstetrics and Gynecology, Xijing Hospital, Air Force Military Medical University, Shannxi, China.
Department of Obstetrics and Gynecology, Xi'an People's Hospital (Xi'an Fourth Hospital), Shannxi, China.
Front Oncol. 2025 Aug 26;15:1615749. doi: 10.3389/fonc.2025.1615749. eCollection 2025.
This study aims to investigate the clinical and pathologic characteristics, treatment, and prognosis of primary melanoma in the female reproductive system.
A retrospective analysis was performed using the clinical and pathological data of 33 patients with melanoma of the female lower genital tract who presented at the Department of Gynecology at Xijing Hospital of Air Force Military Medical University between June 2006 and July 2022. Pathological review and immunohistochemical staining were performed in all cases to confirm the diagnosis.
A total of 15 (45%) cases of primary melanoma involved the vulva, 16 (49%) involved the vagina, and two (6%) involved the cervix. The HMB-45 positive rate was 93%, the S-100 positive rate was 90%, and the Vim positive rate was 100%. Of these 33 cases, we had complete clinical information on 27 of them who received various comprehensive treatments including surgical treatment, postoperative radiotherapy, chemotherapy, immune therapy, or targeted therapy. Patients with stage III-IV comprised 67% of all cases, and the average duration of follow-up was 24 months. The 2-year recurrence rate was 82%, and the 3-year overall survival rate was 42%.
The incidence of melanoma in the female reproductive system is low, and the prognosis is poor owing to the difficulty of early diagnosis and the high possibility of metastasis. Individualized comprehensive treatment like surgical treatment combined with immunotherapy can prolong the survival time and improve the prognosis of patients.
本研究旨在探讨女性生殖系统原发性黑色素瘤的临床及病理特征、治疗方法和预后情况。
对2006年6月至2022年7月在空军军医大学西京医院妇科就诊的33例女性下生殖道黑色素瘤患者的临床和病理资料进行回顾性分析。所有病例均进行病理复查和免疫组化染色以确诊。
共有15例（45%）原发性黑色素瘤累及外阴，16例（49%）累及阴道，2例（6%）累及宫颈。HMB-45阳性率为93%，S-100阳性率为90%，波形蛋白（Vim）阳性率为100%。在这33例病例中，我们掌握了其中27例的完整临床信息，这些患者接受了包括手术治疗、术后放疗、化疗﹑免疫治疗或靶向治疗在内的各种综合治疗。Ⅲ-Ⅳ期患者占所有病例的67%，平均随访时间为24个月。2年复发率为82%，3年总生存率为42%。
女性生殖系统黑色素瘤发病率低，由于早期诊断困难及转移可能性高，预后较差。手术治疗联合免疫治疗等个体化综合治疗可延长患者生存时间，改善预后。
