Duan JL, Yang J, Zhang YL, Huang WT. Amelanotic primary cervical malignant melanoma: A case report and review of literature. World J Clin Oncol 2024; 15(7): 953-960 [PMID: 39071457 DOI: 10.5306/wjco.v15.i7.953]
Corresponding Author of This Article
Wen-Tao Huang, MD, Director, Department of Pathology, The Affiliated Tongren Hospital, School of Medicine, Shanghai Jiao Tong University, No. 1111 Xianxia Road, Changning District, Shanghai 200332, China. wt.huang@hotmail.com
Research Domain of This Article
Pathology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jin-Lin Duan, Jing Yang, Wen-Tao Huang, Department of Pathology, The Affiliated Tongren Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200332, China
Yong-Long Zhang, Laboratory of Targeted Therapy and Precision Medicine, Department of Clinical Laboratory, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
Author contributions: Duan JL and Yang Y contributed to the histological examinations and collection of patient data; Duan JL and Yang Y assembled the data; Huang WT and Zhang YL performed data analysis and interpretation; Huang WT, Duan JL, and Zhang YL wrote the manuscript; All authors read and approved the final manuscript; Huang WT and Zhang YL confirm the authenticity of all the raw data; Duan JL and Yang J contributed equally to this work.
Supported bythe National Natural Science Foundation of China, No. 82073258; the Excellent Youth Program of Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. ynyq202105; the Research Fund of Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No. TRYJ201702; Start-up Funding for Talent Introduction, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No. TR2020rc04; and Special Project of Medical and Health Research in Changning District, Shanghai, No. CNKW2017Y09.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Tao Huang, MD, Director, Department of Pathology, The Affiliated Tongren Hospital, School of Medicine, Shanghai Jiao Tong University, No. 1111 Xianxia Road, Changning District, Shanghai 200332, China. wt.huang@hotmail.com
Received: March 20, 2024 Revised: May 8, 2024 Accepted: June 7, 2024 Published online: July 24, 2024 Processing time: 117 Days and 14.7 Hours
Abstract
BACKGROUND
Primary malignant melanoma of the cervix (PMMC) is an extremely rare disease that originates from primary cervical malignant melanoma and frequently represents a challenge in disease diagnosis due to unclarified clinical and histological presentations, particularly those without melanin.
CASE SUMMARY
Here, we report a case of amelanotic PMMC, with a history of breast cancer and thyroid carcinoma. The patient was finally diagnosed by immunohistochemical staining and staged as IB2 based on the International Federation of Gynecology and Obstetrics with reference to National Comprehensive Cancer Network guidelines and was treated with radical hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. She then received combination therapy consisting of immunotherapy with tislelizumab and radiofrequency hyperthermia. She has remained free of disease for more than 1 year.
CONCLUSION
The differential diagnosis process reenforced the notion that immunohistochemical staining is the most reliable approach for amelanotic PMMC diagnosis. Due to the lack of established therapeutic guidelines, empirical information from limited available studies does not provide the rationale for treatment-decision making. By integrating 'omics' technologies and patient-derived xenografts or mini-patient-derived xenograft models this will help to identify selective therapeutic window(s) and screen the appropriate therapeutics for targeted therapies, immune checkpoint blockade or combination therapy strategies effectively and precisely that will ultimately improve patient survival.
Core Tip: We report a case of unsuspected amelanotic primary malignant melanoma of the cervix (PMMC) with a history of breast cancer. The patient underwent radical hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy, and then received radiotherapy combined with immunotherapy. She has remained free of disease for more than 1 year. The successful management of this patient underscores the critical role of routine immunohistochemical staining during cervical cancer diagnosis to exclude unsuspected PMMC, and adjuvant immunotherapy may be an option for PMMC.
