R.I. Knyazev1, 2, A.S. Shevchuk1, 3, A.S. Krylov1, D.R. Babayan1, S.M. Silov4
1N.N. Blokhin Russian Cancer Research Center, Moscow
2Russian Medical Academy of Continuing Professional Education, Moscow
3N.I. Pirogov Russian National Research Medical University, Moscow
4Shatura Hospital, Shatura
Knyazev R.I. — PhD (Medicine), Researcher at the Department of Oncogynecology, Associate Professor of the Department of Oncology and Palliative Medicine
24, Kashirskoe highway, 115478 Moscow, Russian Federation, tel.: +7-926-284-77-46, e-mail: sluwba@mail.ru, ORCID ID: 0000-0002-6341-0897
Abstract. Vaginal melanoma is a rare disease associated with low survival and poor prognosis. The cause of this disease is not fully understood; it often develops when limited or diffuse melanosis happened or on the intact mucosa of the external female genitalia. Due to its localization, the diagnosis of vaginal melanoma can be associated with certain difficulties. The main clinical manifestations include the presence of a palpable formation and bloody discharge from the genital tract. The leading method of treating this disease is considered to be surgical, in which the primary tumor is removed. The need to assess the lymph nodes condition can only be extrapolated from the treatment recommendations for malignant melanoma of the skin. At present, pelvic or inguinal-femoral lymphadenectomy can be performed to examine regional lymph nodes taking into account the localization of melanoma in the vagina. An alternative is the detection of sentinel lymph nodes (SLN), which can be made by radioisotope or fluorescence diagnostics. In some cases, their combination is possible to increase the frequency of sentinel lymph nodes detection. In our clinical example, a patient with melanoma of the middle third of the vagina underwent surgical treatment with sentinel lymph node biopsy (SLNB) using a combined method of their detection.
Key words: vaginal melanoma, sentinel lymph node biopsy, radionuclide method, fluorescent method, indocyanine green, technetium-99m.