Korean J Obstet Gynecol.  2012 May;55(5):343-347. 10.5468/KJOG.2012.55.5.343.

Primary malignant melanoma of the uterine cervix: A case report

• Yun NR
• Park JW
• Park JH
• Choi SJ
• Hwang SO

• KMID: 2078152
• DOI: http://doi.org/10.5468/KJOG.2012.55.5.343

Abstract

After the discovery of melanocytes in the cervix in 1959, it was recognized that primary malignant melanoma of the cervix exists as a separate entity. A 74-year-old woman visited hospital for vaginal bleeding from a black colored cervical mass. The pathology of cervical punch biopsy showed a malignant melanoma with positive immnunohistochemical stainings for S100 protein and HMB-45 antibody. Abdominal radical hysterectomy with pelvic and paraaortic lymphadenectomy was performed. The final pathology was a malignant melanoma of the cervix with metastases for both external iliac lymph nodes and tumor involvement in the margin of vaginal resection. She received cisplatin based concurrent chemoradiotherapy postoperatively. But 6 months later, she received another chemotherapy with dacarbazine and cisplatin for recurrence. We report a case of a 74-year-old patient with a malignant melanoma of the uterine cervix with a brief review.

Keyword

Malignant melanoma; Uterine cervix; Vaginal bleeding

MeSH Terms

Aged
Biopsy
Cervix Uteri
Chemoradiotherapy
Cisplatin
Dacarbazine
Female
Humans
Hysterectomy
Lymph Node Excision
Lymph Nodes
Melanocytes
Melanoma
Neoplasm Metastasis
Recurrence
Uterine Cervical Neoplasms
Uterine Hemorrhage
Cisplatin
Dacarbazine
Melanoma
Uterine Cervical Neoplasms

Figure

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  Fig. 1 Computed tomography findings of preoperation; upper margin of mild enhancing cervical mass. The multiple small lymph nodes in both external iliac chains were enlarged.

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  Fig. 2 Positron emission tomography findings of abnormal fluoro-D-glucose uptake in whole cervix mass.

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  Fig. 3 Histologic findings are showing proliferation of malignant melanin-producing melanocytes (A). Most of the atypical cells are positive for HMB-45 (B) and S100 (C) (A: H&E, ×20; B: Immunohistochemical stain, ×20; C: Immunohistochemical stain for S100 protein after melanin bleaching, ×20). The uterus was enlarged with a huge dark brown ulcerofungating tumor arising in the exocervix and endocervix, extending to the vagina with near full-thickness invasion of the cervical wall (D).

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  Fig. 4 About 6 months after radical hysterectomy, newly appeared multiple well-defined various size pulmonary nodule in right lung and left lower lobe that suspected pulmonary metastasis. Computed tomography findings of round shape well-defined 0.6 cm and 0.4 cm sized pulmonary nodules in right lower lobe (allow).

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  Fig. 5 Positron emission tomography-computed tomography imaging. Abnormal FDG uptake in newly appeared 2 cm sized right adrenal gland nodule 6 month after radical hysterectomy.

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