PMC7225290_01
Representative histopathologic images of the ulcerated primary pigmented mucosal melanoma of the Urethra. (A) Overview image of the histopathologic sample, H&E stained in 2,5-fold magnification. (B) Detailed view, H&E stained in 10-fold magnification.
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F1
Only 1 month after the intervention intravaginal mucosal metastases were diagnosed and histologically confirmed (Figure 1).
Clinical and MR image of intravaginal mucosal metastasis of a malignant melanoma of the urethra. A/B: Visual appraisal with speculum. (A) Target lesion before injection of T-VEC. Baseline image shows a pigmented ulcerated mucosal tumor (arrow). (B) Target lesion after seven injections of T-VEC: partial response with substantial regression of the injected mucosal metastasis (arrow) and cessation of intravaginal bleeding. C/D MR image. (C) Transverse T2-weighted fat suppressed MR image shows labial metastasis (arrow) before injection of T-VEC. (D) Transverse T2-weighted fat suppressed MR image 2 months upon T-VEC therapy shows complete disappearance of labial metastasis (arrow indicating the original location).
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F2
Imaging confirmed loco-regional progress without distant metastases (Figure 2). After five injections T-VEC yielded a partial response with substantial regression of the injected mucosal metastases and cessation of intravaginal bleedings (Figure 2).
Summary of the sequential treatment in our case of advanced mucosal melanoma.
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F3
Treatment with imatinib achieved a considerable regression of all metastatic tumor sites with a still ongoing response (summary of the sequential therapies: see Figure 3).