Vaginal Fistula in a Patient with Relapsed Ovarian Cancer and Amelanotic Melanoma

Malignant vaginal melanoma is extremely rare and accounts for fewer than 0.3% of all melanomas in women. Amelanotic malignant melanoma is a subtype of melanoma with little or no pigment on visual inspection. The simultaneous occurrence of amelanotic melanoma of the vagina and serous ovarian cancer is extremely rare. A 61-year-old patient was referred to our hospital with recurrent ovarian cancer in association with a vaginorectal fistula. The first diagnosis was performed in 2009. The patient underwent multi-ovarian cancer recurrences after the primary cytoreductive surgery, especially in the vaginal vault, with several different lines of chemotherapy. The pathological results on this occasion demonstrated recurrent ovarian cancer with a component of amelanotic melanoma in the region of a vaginorectal fistula. We recommend detailed immunohistochemical staining, especially for recurrent ovarian cancer in combination with abnormal localizations or manifestations, in order to reveal any associations with another tumor.