Female genital tract melanoma: Analysis from a regional cancer institute

Objective- Malignant melanoma of genital tract comprises 3% of overall melanomas afflicting females. They are characterized by poor prognosis with 5-year survival of 0-25% and high incidence for distant metastasis. This study was performed to assess various clinical features, treatment options and management of genital melanomas.
Material and methods- This was a retrospective analysis where records of patients with genital melanomas between 2005 to 2018 were reviewed to obtain demographic and clinical information, including age of diagnosis, presenting symptoms, performance status, pathology reports, treatment, follow-up and survival. Results- Between 2005 to 2018, 31 women were analyzed. The median age was 53.5 years (range 28.5-85).Vaginal bleeding was the commonest presenting symptom (80.6%) followed by discharge (29%), mass in vagina/perineum (19.3%), pain (16.1%) and difficulty in micturition (9.6%). The commonest site of origin was vagina (67.7%) followed by vulva (19.3%) and cervix ( 12.9%). Tumor diameter was more than 3 cm in 74.2 % (23/31). Out of 31 patients, only 16 opted for treatment. Four patients underwent surgery, 10 received primary chemotherapyand two needed palliative radiotherapy for heavy bleeding. The median survival in the treatment groupwas 5 months (2.5-28 months), almost similar to patients not receiving any treatment (5 months, 2-11).Conclusion- Genital melanoma are rare but aggressive tumors. Diagnosisis usually made with biopsy. No effective treatment strategy is yet available. However, surgery is the preferred first line treatment while radiotherapy and chemotherapy had been used in adjuvant setting.