Περίληψη:
Background. Gynecologic melanomas are extremely rare malignancies, and
primary malignant melanoma of the cervix (PMMC) is the rarest among them
all, with less than 100 cases reported so far. Although some conditions
have been correlated with the pathogenesis of this entity, no specific
risk factor has been yet identified, with vaginal bleeding being the
most common symptoms. The diagnosis is based on physical examination
with speculum assessment and cytologic and histopathologic findings
accompanied with immunohistochemical staining of lesion's biopsies.Case
Presentation. We report a case of PMMC in a 34-year-old para-2 patient,
among the youngest cases of PMMC reported, that presented to our clinic
for routine examination. Gynecologic examination demonstrated a dark,
heavily fully pigmented cervical growth completely covering the entire
external cervical os. Biopsy obtained and showed malignant melanoma. She
underwent radical hysterectomy with bilateral salpingo-oophorectomy and
pelvic lymphadenectomy. The pathological diagnosis was FIGO stage IB1
PMMC. Despite 2 courses of anti-PD-1 antibody (Nivolumab) treatment, the
patient passed away 13 months after diagnosis (12 months after
surgery).Conclusions. Early diagnosis and subsequently early treatment
are of high importance regarding patients' prognosis and survival. No
standardized protocols or treatment guidelines specific for this rare
cancer have been issued; thus, clinicians are called to assess each case
individually. Current treatment options are based on surgical excision
mostly with radical hysterectomy, but in advanced or recurrent state of
the disease, other treatment modalities, such as chemotherapy,
radiotherapy, and immunotherapy, can be employed. Prognosis for these
patients is very poor, and survival rate remains extremely low, with the
median OS reported being less than 2 years. Reporting and publishing of
such cases are both of paramount importance for the better understanding
of this uncommon cervical malignancy, and further biological and
clinical investigations are required for more suitable and effective
therapies to be determined. A new staging system, specific to PMMC,
could be of great use for the better correlation of the disease's stage
and prognosis of these patients.
Συγγραφείς:
Diakosavvas, Michail
Fasoulakis, Zacharias N.
Kouroupi, Maria
and Theodora, Marianna
Inagamova, Lola
Tsatsaris, Georgios and
Nikolaou, Panagiotis
Frangia-Tsivou, Konstantina
Giatromanolaki,
Alexandra
Kontomanolis, Emmanuel N.
