Objective: Report the diagnosis and therapeutic approach in two cases of primary malignant melanoma of the vagina.
Results: Malignant melanoma is rarely localized in the vagina, resulting from the malignant transformation of an ectopic melanocyte during menopause. The clinical diagnosis is often made in an advanced stage with a variable degree of pigmentation, usually on the anterior aspect of the vagina. Surgical exeresis should be extensive with a 1-cm safety margin. Radiotherapy may be effective as a complementary treatment for limited surgery or as first intention therapy aimed as improving local control before surgery.
Conclusion: Locoregional relapse occurs in 60% of the cases, emphasizing the importance of local treatment. The prognosis is unfavourable with a 23 month mean survival. Total survival at 5 years is only 17%.