ABSTRACT
Primary melanoma of the vagina is rare, accounting for 2.6-2.8% of all primary malignant tumor of the vagina and 0.4-0.8% of all malignant melanomas in the female. Melanocytes are the presumed precursors of malignant melanoma of the vagina; they are embryologically derived from neural crest cells and can be found in the basal portion of the vaginal epidermis in 3% of normal adult females. Though malignant melanoma may occur anywhere in the vagina, it is most commonly found on the anterior wall and in the distal one-third. Vaginal bleeding is the most common symptom. Histochemical and immunohistochemical procedures confirm the initial diagnosis. Vaginal melanoma is a highly malignant disease; due to the extensive lymphatic invasion and melanoma's propensity for hematogeneous spread, so early metastases are very common. The treatment modalities for the primary management of vaginal melanoma are varied according to the location and extend, individually or in combination, wide local incision, radical surgical extirpation, irradiation, or chemotherapy. Although there have been no consensus as to comprehensive treatment, in the case of upper vaginal melanoma, radical abdominal hysterectomy with bilateral salpingo-oophorectomy with pelvic lymph node dissection is generally advocated. Regardless of primary therapy chosen, result of the treatment of vaginal melanoma has been uniformly poor. We experienced a case of malignant melanoma of the vagina confirmed pathohistologically after radical abdominal hysterectomy with bilateral salpingo-oophorectomy and presented with a brief review of literature.
Subject(s)
Adult , Female , Humans , Consensus , Diagnosis , Drug Therapy , Epidermis , Hysterectomy , Lymph Node Excision , Melanocytes , Melanoma , Neoplasm Metastasis , Neural Crest , Uterine Hemorrhage , VaginaABSTRACT
Pelvic actinomycosis is a chronic, progressive, granulomatous and suppurative disease caused by an anaerobic or microaerobic Gram-positive organism, not fungi. Actinomyces species exhibit branching, filamentous growth and appear in the human skin, oral cavity, gastrointestinal tract. Actinomyces infection in human is relatively rare, however, prolonged use of an intrauterine contraceptive device (IUD) is a well known risk factor of pelvic actinomycosis. Pelvic actinomycosis can mimick pelvic malignancy leading to mutilating surgical excision, and diagnostic problems necessitated a laparotomy in many patients. The pathohistological diagnosis is based on the characteristic microscopic image and specific staining of sulfur granule. Adequate surgical excision and administration of antibiotics show good prognosis. We experienced 2 cases of pelvic actinomycosis with the intestinal obstruction, confirmed patho- histologically after laparotomy.
Subject(s)
Humans , Actinomyces , Actinomycosis , Anti-Bacterial Agents , Diagnosis , Fungi , Gastrointestinal Tract , Intestinal Obstruction , Intrauterine Devices , Laparotomy , Mouth , Prognosis , Risk Factors , Skin , SulfurABSTRACT
Pelvic actinomycosis is a chronic, progressive, granulomatous and suppurative disease caused by an anaerobic or microaerobic Gram-positive organism, not fungi. Actinomyces species exhibit branching, filamentous growth and appear in the human skin, oral cavity, gastrointestinal tract. Actinomyces infection in human is relatively rare, however, prolonged use of an intrauterine contraceptive device (IUD) is a well known risk factor of pelvic actinomycosis. Pelvic actinomycosis can mimick pelvic malignancy leading to mutilating surgical excision, and diagnostic problems necessitated a laparotomy in many patients. The pathohistological diagnosis is based on the characteristic microscopic image and specific staining of sulfur granule. Adequate surgical excision and administration of antibiotics show good prognosis. We experienced 2 cases of pelvic actinomycosis with the intestinal obstruction, confirmed patho- histologically after laparotomy.