Obstet Gynecol Sci.  2018 Jul;61(4):524-528. 10.5468/ogs.2018.61.4.524.

Primary malignant melanoma of the uterine cervix treated with pembrolizumab after radical surgery: a case report and literature review

• Kim MS
• Choi CH
• Kim TJ
• Lee JW
• Lee J
• Bae DS
• Kim BG

• KMID: 2439727
• DOI: http://doi.org/10.5468/ogs.2018.61.4.524

Abstract

Malignant melanoma of the genital tract is a rare disease that is usually diagnosed by chance. When a definite diagnosis is delayed, the prognosis is very poor without standardized treatment. Herein, we describe a 40-year-old patient who presented with a history of bloody vaginal discharge for 7 months. Gynecological examination showed an exophytic, hard and pigmented cervical mass involving the upper vagina. The patient was diagnosed with cervical melanoma after a punch biopsy and underwent a radical hysterectomy, upper vaginectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. After surgeries, the patient underwent 2-cycles of adjuvant immunotherapy with pembrolizumab, but died within 8 months. In this report, treatment with pembrolizumab after radical surgery was not effective for this patient who had a primary cervical melanoma that metastasized to bone and lung tissue. We do not know why pembrolizumab was ineffective for this patient, but there are several possible explanations; further research is needed.

Keyword

Melanoma; Pembrolizumab; Antibodies, monoclonal, humanized; Uterine Cervical Neoplasms

MeSH Terms

Adult
Antibodies, Monoclonal, Humanized
Biopsy
Cervix Uteri*
Diagnosis
Female
Gynecological Examination
Humans
Hysterectomy
Immunotherapy
Lung
Lymph Node Excision
Melanoma*
Prognosis
Rare Diseases
Uterine Cervical Neoplasms
Vagina
Vaginal Discharge
Antibodies, Monoclonal, Humanized