2004 Volume 43 Issue 6 Pages 390-396
Background: Malignant melanoma of the uterine cervix is rare. We report such a case that mimicked leiomyosarcoma cytologically and histologically, with little melanin pigmentation at the initial manifestation.
Case: A 66-year-old woman suspected of carcinoma in situ or microinvasive carcinoma based on a cancer screening cervical smear evidenced no abnormality histologically or in further cytology smears. One year later, cytological reexamination showed malignant cells suggesting leiomyosarcoma. Although colposcopically directed biopsy was normal, malignant melanoma was detected in endocervical curettage necesitating total abdominal hysterectomy and bilateral salpingo-oophorectomy with intrapelvic lymphadenectomy. Pathological examination showed malignant melanoma of the uterine cervix with lymph node metastasis. Immunohistochemically, the tumor aberrantly expressed both muscle and melanoma markers. Despite systemic chemotherapy, the patient died one year and 8 months after surgery.
Conclusion: Malignant melanoma of the uterine cervix is rare. The few melanin granules evidenced may be confused with leiomyosarcomas, either morphologically or immunophenotypically.
