Multifocal Malignant Melanoma of Female Genital Tract

A 75-year-old patient was referred with vaginal bleeding. herphysical exam showed two flat dark plaques on the posteriorfourchette, mostly on left lateral side of the vulva, a black softmucosal nodule was present on the left lateral side of uppervagina, and a polypoid ulcerative cervical lesion extended intothe right parametrium. cervical and vaginal biopsies were infavor of malignant melanoma, while vulvar biopsy was in favorof lentigo maligna melanoma. the diagnosis was confirmedusing immunohistochemical studies with si 00 andhmb 45. the patient was treated by wide local excision of thevulvar lesion followed by high-doses of fractionation radiotherapyof the cervix and upper vagina. due to advanced andaggressive melanoma of the cervix, in comparison to the lentigomaligna of the vulva, and the presence of vaginal melanomason the opposite site of the cervical lesion, it is suggestedthat the origin of these two lesions are multi focalrather than the direct extension.