Nodal detection in malignant melanoma of the vagina using laparoscopic ultrasonography.

Gynecol Oncol

Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong.

Published: March 2004

AI Article Synopsis

  • Primary malignant melanoma of the vagina is rare and has a worse prognosis compared to other types of melanomas and vaginal cancers.
  • A 40-year-old Chinese woman was diagnosed with vaginal melanoma, underwent surgery that included the removal of the tumor and affected lymph nodes, but unfortunately, she died shortly after despite clear surgical margins and radiation therapy.
  • This case emphasizes the need for careful evaluation for metastatic disease before aggressive surgery, marking the first instance of using laparoscopic ultrasound to detect metastatic lymph nodes in vaginal melanoma.

Article Abstract

Background: Primary malignant melanoma of the vagina is a rare variant of melanoma. It has worse prognosis compared to nongenital melanomas or other vaginal malignant neoplasms.

Case: A 40-year-old Chinese was diagnosed vaginal melanoma. Laparoscopic ultrasonography (USG) was used to search for abnormal pelvic and abdominal lymph nodes. Two metastatic pelvic lymph nodes were detected and excised. The vaginal tumour was removed by hysterectomy and partial vaginectomy. Despite a clear surgical margin and adjuvant radiotherapy, the patient died shortly after the operation.

Conclusion: Patient with vaginal melanoma has grave prognosis, especially when metastatic disease presents. Radical surgery appears unjustified as a routine, it is essential to exclude lymphatic and distant metastases before embark to radical surgery. This report presents the first case of laparoscopic ultrasonographic detection of metastatic pelvic lymph nodes in patient with vaginal melanoma.

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Source
http://dx.doi.org/10.1016/j.ygyno.2003.11.036DOI Listing

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