Obstet Gynecol Sci.  2018 Mar;61(2):282-285. 10.5468/ogs.2018.61.2.282.

A rare melanoma feature with primary ovarian origin: a case report and the literature review

• Paola A
• Maria RS
• Laura C
• Elena N
• Orlando C
• Teresio M

• KMID: 2420185
• DOI: http://doi.org/10.5468/ogs.2018.61.2.282

Abstract

Primary ovarian melanoma arising on a mature ovarian cystic teratoma is extremely rare. As best of our knowledge, to date, 49 cases have been reported in literature. Few information was reported about best management and therapy. We present a case occurred in a 69-year-old woman, without symptoms, who come to our unit for stress incontinence. A pelvic mass was detected and, after imaging evaluation, surgery was performed. The diagnosis was ovarian melanoma arose on a mature teratoma. No other adjuvant treatment was proposed after surgery. She died 9 months after the first diagnosis. Primary ovarian melanoma is a definite entity associated with a variable natural history and poor prognosis. Differential diagnosis is a challenge for the pathologist, because it must be differentiated by metastatic melanoma. The corner stone treatment of this disease is surgery; however, chemotherapy, immunotherapy, and target therapy seem to have a role.

Keyword

Ovarian cancer; Melanoma; Teratoma

MeSH Terms

Aged
Diagnosis
Diagnosis, Differential
Drug Therapy
Female
Humans
Immunotherapy
Melanoma*
Natural History
Ovarian Cysts
Ovarian Neoplasms
Prognosis
Teratoma

Figure

• 

  Fig. 1 (A) cyst wall (original magnification ×10). (B) hematoxylin-eosin (original magnification ×40). (C) hematoxylin-eosin with brown pigment (original magnification ×40). (D) Immunostain for Melan A shows a diffuse, intensively cytoplasmic positive reaction.

Reference

1. O'Gorman T, Olaitan A. Primary malignant melanoma arising in an ovarian cystic teratoma. Eur J Gynaecol Oncol. 2009; 30:88–89.

2. Sugiyama VE, Chan JK, Kapp DS. Management of melanomas of the female genital tract. Curr Opin Oncol. 2008; 20:565–569.

3. Andrews HR. Primary Melanotic sarcoma of the ovary. Trans Obstet Soc (Lond). 1901; 43:228–231.

4. Moore RG, Chung M, Granai CO, Gajewski W, Steinhoff MM. Incidence of metastasis to the ovaries from nongenital tract primary tumors. Gynecol Oncol. 2004; 93:87–91.

5. Cronje HS, Woodruff JD. Primary ovarian malignant melanoma arising in cystic teratoma. Gynecol Oncol. 1981; 12:379–383.

6. Boughton RS, Hughmanick S, Marin-Padilla M. Malignant melanoma arising in an ovarian cystic teratoma in pregnancy. J Am Acad Dermatol. 1987; 17:871–875.

7. Hyun HS, Mun ST. Primary malignant melanoma arising in a cystic teratoma. Obstet Gynecol Sci. 2013; 56:201–204.

8. Vimla N, Kumar L, Thulkar S, Bal S, Dawar R. Primary malignant melanoma in ovarian cystic teratoma. Gynecol Oncol. 2001; 82:380–383.

9. Puzanov I, Flaherty KT. Targeted molecular therapy in melanoma. Semin Cutan Med Surg. 2010; 29:196–201.