Two Cases of Primary Melanoma of the Uterine Cervix.

Abstract

BACKGROUND This study reports on 2 cases of cervical melanoma with similar presentations but at different stages, and the treatment strategy varied accordingly, and we review the literature on the characteristics, diagnosis, and management of cervical melanoma. CASE REPORT Case 1: A 69-year-old woman with abnormal vaginal bleeding was diagnosed with advanced cervical melanoma, staged as International Federation of Gynecology and Obstetrics (FIGO) Stage IVB, involving multiple metastases. Despite chemoradiotherapy and immunotherapy (nivolumab), the disease progressed rapidly, and the patient died 4 months after diagnosis. Case 2: A 75-year-old woman with cervical melanoma, staged as FIGO Stage IIIc, underwent concurrent chemoradiotherapy, surgery, and adjuvant brachytherapy. After initial stability, recurrence occurred 17 months later, followed by metastases. Palliative care was started after treatment intolerance, and the patient died 7 years after the diagnosis. CONCLUSIONS Cervical melanoma is an exceptionally rare and highly aggressive malignancy with a poor prognosis, often characterized by nonspecific symptoms. Diagnosis is based on pathological findings and immunohistochemical markers such as HMB-45, Melan-A, and S-100. The FIGO staging system is used for staging, and radical hysterectomy remains the primary treatment for achieving clear margins. Adjuvant therapies, including chemotherapy, radiation, and immunotherapy, are essential for managing advanced and metastatic cases. However, challenges persist regarding standardized treatment protocols, and further research into emerging therapies is necessary. Increasing awareness and improving diagnostic methods are vital for improving survival and quality of life for patients with this disease.