PRIMARNI MELANOM VAGINE
Sažetak
Primarni melanom vagine predstavlja redak tip melanoma sluzokože, koji čini od 0,3% do 0,8% svih melanoma kod žena, a manje od 3% maligniteta vagine.
Sedamdesetosmogodišnja žena je kao tegobe navela peckanje u vagini, vodenasti iscedak iz vagine i dizuriju, napominjući da je u poslednja četiri meseca to postalo češće. Pacijentkinji je urađena potpuna ekscizija tumora. Tumorske ćelije su imunohistohemijski bile snažno pozitivne na SOX10, HMB-45 i S100 protein. Histopatološka analiza tumora pokazala je ćelije epitelioidnog melanoma u vertikalnoj (invazivnoj) fazi rasta. Većina tumorskih ćelija sadržala je tamnobraon intracelularni pigment, a zabeleženo je i prisustvo površinske mikroskopske ulceracije. Debljina tumora je iznosila 12 mm. Mitotička stopa je bila 15 mitotičkih figura po 1 mm2, sa limfovaskularnom invazijom koja je bila pozitivna. Nisu primećene ni perineuralna ni intraneuralna infiltracija. Nije bilo ni regresije tumora ni mikroskopskih satelita. Na margini duboke resekcije nije bilo tumorskih ćelija. Prema grupi AJCC 8. stadijuma za melanom, ovo je bio slučaj stadijuma IIC (T4b, N0, M0).
Hirurška resekcija za koju se koristi VLE (engl. volumetric laser endomicroscopy ‒ VLE) ostaje glavni standard u lečenju ove agresivne bolesti, kod koje je ukupno preživljavanje pacijentkinja kraće. Melanom sluzokože koji nastaje u zidovima vagine često je klinički teže dijagnostikovana lezija, tako da su brza biopsija i pravovremena i tačna dijagnoza od presudnog značaja.
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