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Primary malignant melanoma of the uterine cervix treated with ultraradical surgery: a case report.

Calderón-Salazar L, Cantú de Leon D, Perez Montiel D, Almogabar-Villagrán E, Villavicencio V, Cetina L - ISRN Obstet Gynecol (2010)

Bottom Line: The patient was under surveillance for 8 years of followup without evidence of local or distant disease.The majority of case reports found suggests radical hysterectomy as the treatment indicated for these patients.Notwithstanding this, survival is very short when patients are treated in this manner.

View Article: PubMed Central - PubMed

Affiliation: Department of Gynecologic Oncology, Instituto Nacional de Cancerologia, 14080 Mèxico, Mexico.

ABSTRACT
Primary melanomas of the uterine cervix are rare tumors with no more than 60 cases reported in the world literature. Poor prognosis is considered for the neoplasia itself as well as for diagnostic tardiness. There is no standard treatment; however, radical surgery is the treatment cornerstone. Our aim was to present the case of a 34-year-old woman with a primary malignant melanoma in the uterine cervix with affectation of the posterior face of the vagina without metastasis. Total infraelevator pelvic exenteration and adjuvant radiotherapy was performed. The patient was under surveillance for 8 years of followup without evidence of local or distant disease. The majority of case reports found suggests radical hysterectomy as the treatment indicated for these patients. Notwithstanding this, survival is very short when patients are treated in this manner. Based on our results and on those reported in the literature, we propose initial treatment with total pelvic exenteration as optimal management for this neoplasia in its initial form.

No MeSH data available.


Related in: MedlinePlus

Contrast enhanced CT scan of the pelvis showing a solid cervical mass without evidence of direct involvement of bladder or rectum.
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fig1: Contrast enhanced CT scan of the pelvis showing a solid cervical mass without evidence of direct involvement of bladder or rectum.

Mentions: On initial physical exploration at this Institute, cervix-dependent tumor was noted that extended to the right pelvic wall, of petraeus consistency, and another at the level of the anterior wall of the vagina. A new biopsy was taken, reporting malignant melanoma. Chest X-ray, cystoscopy, and colonoscopy were performed, and reported as normal, in addition to complete revision of skin and eyes, discarding other sites of melanocytic lesions. Additionally, a Computed tomography (CT) was requested, which reported tumor in the pelvic floor toward the right annex of approximately 8 × 6 cm, which displaced the bladder and ureters (Figure 1). Due to the extension of the lesion, the patient was considered to be a candidate for exploratory laparotomy, and total pelvic exenteration was planned, which was performed in March 2001. Reconstruction of the digestive and urinary tracts was carried out with a terminal colostomy and Bricker ileal conduit operation, respectively. The final histopathological report of the surgical specimen obtained demonstrated malignant melanoma of the cervix of 7.5 × 5 cm, surgical margins were reported as negative. Intrahospital evolution was satisfactory, and the patient was discharged on day 10. Adjuvant radiotherapy was administered, 21 Gy in three sessions, concluding in June 2001. The patient has been under routine surveillance for 8 years, and has only referred four occasional urinary tract infections, which have been resolved medically. To the moment of this report, there has been no evidence of local or distant recurring disease.


Primary malignant melanoma of the uterine cervix treated with ultraradical surgery: a case report.

Calderón-Salazar L, Cantú de Leon D, Perez Montiel D, Almogabar-Villagrán E, Villavicencio V, Cetina L - ISRN Obstet Gynecol (2010)

Contrast enhanced CT scan of the pelvis showing a solid cervical mass without evidence of direct involvement of bladder or rectum.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3101984&req=5

fig1: Contrast enhanced CT scan of the pelvis showing a solid cervical mass without evidence of direct involvement of bladder or rectum.
Mentions: On initial physical exploration at this Institute, cervix-dependent tumor was noted that extended to the right pelvic wall, of petraeus consistency, and another at the level of the anterior wall of the vagina. A new biopsy was taken, reporting malignant melanoma. Chest X-ray, cystoscopy, and colonoscopy were performed, and reported as normal, in addition to complete revision of skin and eyes, discarding other sites of melanocytic lesions. Additionally, a Computed tomography (CT) was requested, which reported tumor in the pelvic floor toward the right annex of approximately 8 × 6 cm, which displaced the bladder and ureters (Figure 1). Due to the extension of the lesion, the patient was considered to be a candidate for exploratory laparotomy, and total pelvic exenteration was planned, which was performed in March 2001. Reconstruction of the digestive and urinary tracts was carried out with a terminal colostomy and Bricker ileal conduit operation, respectively. The final histopathological report of the surgical specimen obtained demonstrated malignant melanoma of the cervix of 7.5 × 5 cm, surgical margins were reported as negative. Intrahospital evolution was satisfactory, and the patient was discharged on day 10. Adjuvant radiotherapy was administered, 21 Gy in three sessions, concluding in June 2001. The patient has been under routine surveillance for 8 years, and has only referred four occasional urinary tract infections, which have been resolved medically. To the moment of this report, there has been no evidence of local or distant recurring disease.

Bottom Line: The patient was under surveillance for 8 years of followup without evidence of local or distant disease.The majority of case reports found suggests radical hysterectomy as the treatment indicated for these patients.Notwithstanding this, survival is very short when patients are treated in this manner.

View Article: PubMed Central - PubMed

Affiliation: Department of Gynecologic Oncology, Instituto Nacional de Cancerologia, 14080 Mèxico, Mexico.

ABSTRACT
Primary melanomas of the uterine cervix are rare tumors with no more than 60 cases reported in the world literature. Poor prognosis is considered for the neoplasia itself as well as for diagnostic tardiness. There is no standard treatment; however, radical surgery is the treatment cornerstone. Our aim was to present the case of a 34-year-old woman with a primary malignant melanoma in the uterine cervix with affectation of the posterior face of the vagina without metastasis. Total infraelevator pelvic exenteration and adjuvant radiotherapy was performed. The patient was under surveillance for 8 years of followup without evidence of local or distant disease. The majority of case reports found suggests radical hysterectomy as the treatment indicated for these patients. Notwithstanding this, survival is very short when patients are treated in this manner. Based on our results and on those reported in the literature, we propose initial treatment with total pelvic exenteration as optimal management for this neoplasia in its initial form.

No MeSH data available.


Related in: MedlinePlus