The Clinical Analysis Of Primary Malignant Amelanotic Melanoma In The Female Genital Tract

Objective:The main purpose of our experiment is to investigate the clinical and pathological characteristics,diagnosis,treatments, prognosis and prevention of the primary malignant melanoma of female genital tract.Methods:From January1998to December2010,8patients with primary malignant melanoma of female genital tract were treated in Qilu hospital of Shandong university.2cases originated from vulvae,and6cases from vaginal. The age of patients were between31-70years old.the median age of the patients was46,and4of them were post-menopausal women. The patients were with stage Ⅰ-Ⅳ period according to International Federation of Gynecology and Obstetrics(FIGO). The specimens by biopsy and operation in all cases were not only carried out routine pathological examination of HE staining, but also carried out S-100protein and the Wavy protein (Vimentin) staining, anti-melanoma specific antibody (HMB-45) staining, and cytokeratin (CK) immunohistochemical staining..Results:Of the8cases with malignant melanoma in female genital tract, two cases originated from vulvae, six cases from vagina.In all cases,the expression of S-100protein and wavy protein (Vimentin) was positive, and CK negative;3of them were positive for HMB-45. These patients were followed up8-30months,6cases recurrenced in3,3,6,12,15,19months after initial diagnosis, and3of the6cases died from the disease in13,18,19months after initial diagnosis.Other3cases were survival with tumor. The other2cases have lived8and30months after treatment, respectively. There were no evidence of recurrence.Conclussion:It is easy to be misdiagnosed because signs and symptoms of this disease are nonspecific.The key to diagnose of this disease is depended on pathology, combination of S-100,Vimentin,HMB-45and other immunohistochemical indexes detection. Surgical resection is primary treatment, followed by adjuvant therapy after operation including chemotherapy,radiotherapy and biological,gene therapy.High degree of malignancy andhigh incidence of distant metastasis lead to poor prognosis.to improving understanding of the disease and to avoid misdiagnosis are the premise for treatment. Partial lesion or the entire lesion suspicious lesions were excised for the rapid biopsy and immunohistochemical indicators detect. According to patients’s conditions and pathologic stage, surgical resection and followed by adjuvant therapy, can prolong patients’s life and improve their quality of survival.Significance:As the disease was lack of specificity, early clinical diagnosis was not easily, leading to high rate of misdiagnosis of this disease.So, to raise awareness of this disease and to avoid its misdiagnosis were essential. Early detection, early diagnosis and early treatment, could extend patients’s life,and improvetheir living quality.