EP1178 Diagnosis of the vagina´s melanoma by vaginoscopy

Introduction/Background The incidence of vagina´s melanoma is about 3/10.000.000 women/year. It is typically diagnosed in elderly women at an advanced stage and characterized by early recurrence and a poor prognosis. Methodology We present a case report. Results An 86 years-old woman came to our hospital reporting vaginal bleeding. Vaginal bleeding was the common presenting symptom. Other symptoms were vaginal discharge and vaginal mass. It was typically located in the distal third of the vagina. In our patient vaginal examination was not possible because she had vaginal narrowing, but we could see a black solid mass of 4 cm in the lower third of the vagina, although it was impossible to see the origin. Immunohistochemical analysis of the biopsy of the mass indicated the present of S100 and HMB-45 and other molecular finding as Melan A and SOX10. We perform a vaginoscopy to find out the origin of the mass. We could see two lesions in the distal third of the vagina, in the anterior wall and in the left lateral wall; which otherwise would have been impossible to observe without a hysteroscopy because the patient had a vaginal narrowing. In our case, an expectant treatment was performed given the patient´s advanced age and general status. Conclusion Vagina´s melanoma is a rare type of cancer. Diagnosis of the vagina´s melanoma is made by histological and immunological examination, using special immunostains. If you can´t see the tumor, you can do a vaginoscopy to see them and to do biopsies. To date, there is no consensus regarding the optimal treatment. Surgery is the mainstay of treatment for localized disease while systemic chemotherapy and radiotherapy are appropriate for disseminated or recurrent primary melanoma. Immunotherapy with interferon alpha has been used in some patients and may be useful adjunct therapy, but evidence for this efficacy is lacking. Disclosure Nothing to disclose