General
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• Rare, primary vaginal tumor in elderly (more common in vulva)
• Mean age 60 years, range 38 to 90 years
• Present with vaginal bleeding or vaginal mass
• Associated with melanosis (Arch Pathol Lab Med 1991;115:950)
• Poor prognosis due to local recurrence or distant metastases (Am J Surg Pathol 2002;26:1450)
• Note: 3% of normal vaginas have melanocytes present

Treatment
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• Wide local excision, extenteration with or without lymph node dissection, radiotherapy, chemotherapy

Gross description
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• Soft blue/black polypoid mass, often ulcerated

Micro description
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• Epithelioid or spindled cells, more anaplastic than cutaneous melanomas
• Junctional activity proves local origin although it may be destroyed by tumor

Positive stains
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• S100, HMB45 (73%), MART1 (77%), tyrosinase (81%), MiTF (77%)

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