Malignant Melanoma, Vagina
C. Blake Gilks, MD, FRCPC
Key Facts
Clinical Issues
< 3% of malignant tumors of vagina
Peri- and postmenopausal ages (mean: 57 years)
Distal 1/3 (anterior) of vagina most common site
Poor outcome
5-year survival rate: 14%
Median survival < 2 years
Macroscopic Features
Often pigmented (< 10% nonpigmented)
Microscopic Pathology
Diffuse, nested, trabecular, &/or fascicular pattern
Epithelioid (most frequent), spindled, or combination
In situ component may be present at lateral margins (radial growth phase)
Top Differential Diagnoses
Squamous cell carcinoma
Leiomyosarcoma
Metastatic malignant melanoma
 Malignant melanoma of the vagina commonly presents as polypoid and pigmented masses. In this example, multiple satellite lesions are present. |
 Malignant melanoma shows a diffuse growth of epithelioid cells with abundant eosinophilic to amphophilic cytoplasm. |
TERMINOLOGY
Abbreviations
Malignant melanoma (MM)
Definitions
Malignant neoplasm composed of cells showing melanocytic differentiation
CLINICAL ISSUES
Epidemiology
Incidence
< 0.3% of all malignant melanomas
< 3% of malignant tumors of vagina
Age
Peri- and postmenopausal (mean: 57 years)
Site
Distal 1/3 (anterior) of vagina most common
Presentation
Vaginal bleeding or discharge
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