Case notes
In February 2011, a 67-year-old multiparous woman with a 2-month history of postmenopausal bleeding was admitted to a local hospital, where a cervical biopsy was performed. Histopathologic examination of the tissue sample indicated a cervical malignant melanoma. She was then referred to our institution.
Examination of the head, eyes, ears, nose, and throat revealed a 4 × 2.5–cm yellow papillary mass on the right tonsil. On biopsy, the growth proved to be a pleomorphic adenoma. A gynecologic examination of the atrophic cervix disclosed a 3 × 2.5–cm pigmented papillary mass that was black in color ( Figure 1 ) . A Papanicolaou smear showed round cells with enlarged hyperchromatic nuclei; pigment granules were also seen in some cells ( Figures 2 and 3 ) . The vagina and parametrium were not involved; the uterus was atrophic, mobile, and free of any adnexal mass. No abnormal skin lesions were detected elsewhere on the patient’s body. A chest x-ray and a computed tomography scan of the abdomen and pelvis were negative for metastasis.
Conclusions
The diagnosis was stage IB1cervical malignant melanoma, according to the International Federation of Gynecology and Obstetrics classification system for cervical cancer. Radical hysterectomy, bilateral salpingo-oophorectomy, partial vaginectomy, and pelvic lymphadenectomy (PLA) were performed. The tumor was on the posterior lip of the cervix and extended into the endocervical canal, with a 1-cm depth of invasion ( Figure 4 ) . Histologic examination confirmed the diagnosis ( Figures 5 and 6 ) . The surgical margins and the lymph nodes were tumor free. No chemotherapy or radiotherapy was given in the postoperative period.
