Mélanome malin primitif du vagin : à propos d'un cas et revue de la littérature

Authors report a case of malignant melanoma of the vagina diagnosed in a 48-year-old patient. Vaginal discharge, genital bleeding and a vaginal mass were the beginning symptoms. The physical exam showed a fungating, bleeding and brownish tumor in the lower third of the left sidewall of the vagina measuring 2 × 2.5 cm without extension to the cervix. Vaginal biopsy concluded to a malignant melanoma. The rest of the clinical examination in search of a primary lesion or metastasis was negative thus concluding to the diagnosis of primary malignant melanoma of the vagina, and the tumor stage was II according to FIGO classification. The patient refused radical surgery and a local excision was performed which confirmed the diagnosis of malignant melanoma. External beam radiotherapy was delivered at a dose of 65 Gy to the pelvic area and 45 Gy to the inguinal area. The patient is in complete remission after 5 months. The primary malignant melanoma of the vagina is a rare location of the disease; less than 300 cases are reported in the literature. It is often revealed by vaginal bleeding; its histogenesis was controversial for a long time, the immunohistochemical study is very useful for the diagnosis. Its treatment is not well codified. The prognosis is poor and associated with a high rate of recurrence and short term survival.