Primary malignant melanoma of cervix - a case report

Primary malignant melanoma is a rare neoplasm involving the uterine cervix. It may be misdiagnosed especially when amelanotic, in which case immunohistochemistry is useful in reaching the diagnosis. Though its staging and treatment are not yet well codified, prognosis is generally poor and unpredictable and hence early diagnosis is needed. We present the case of a 39-year-old female patient presenting with bleeding per vaginum. Speculum examination revealed an ulcero-proliferative growth involving the cervix. Microscopic examination of the tumor showed sheets of predominantly monomorphic cells, with few cells showing dark-brown pigment. The cells were positive for S-100 and HMB-45. In view of presence of subtle epitheliotropism, diagnosis of primary melanoma was entertained. Primary cervical melanoma should be considered while diagnosing cervical neoplasms, especially those displaying prominent eosinophilic nucleoli, even though this feature may be present only focally. Special staining and immunohistochemistry should be resorted to, whenever needed, to reach the diagnosis as early as possible. This is essential since cervical melanoma is incurable with the currently available therapies.