# Vaginal melanoma

Source: https://onco.cc/cancers/vaginal-melanoma/  
OnCo record `vaginal-melanoma` (Cancer). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Vaginal melanoma is a very rare, aggressive melanoma of the vaginal lining in older women, usually found late because it is hidden, with the worst outlook of any melanoma site. It is treated with surgery where the tumour can be removed and radiotherapy where it cannot; advanced disease gets the drugs used for mucosal melanoma. Unlike skin melanoma it is as common in black as in white women.

## Summary

Vaginal melanoma is a mucosal melanoma listed among the vaginal tumours in the WHO female genital classification and among the vaginal cancer page's types. In SEER data for 1992 to 2005, 125 vaginal melanomas were recorded against 324 vulvar, with age-adjusted incidence of vulvar and vaginal melanoma per million women of 0.87 in black, 0.75 in American Indian, 1.03 in Asian and Pacific Islander, 1.22 in Hispanic and 1.90 in non-Hispanic white women, and a vaginal white to black ratio of 1.02 to 1 (Melanoma Research 2010). Molecular profiling of 14 vaginal and 37 vulvar melanomas found BRAF mutations in 26 percent of vulvovaginal melanomas, more than in other mucosal melanomas, and other targetable alterations (Cancer 2017).

How it differs from its parent: it is not an HPV-associated carcinoma, so the vaginal cancer page's squamous and adenocarcinoma pathways do not apply; it presents with bleeding or a mass in the lower third of the vagina, spreads early to nodes, lung and liver, and has a five-year survival below that of vulvar melanoma in the literature the sources cite.

How common: under 1 per million women a year, with no racial gradient (Melanoma Research 2010).

Treatment: wide local excision or, for larger tumours, radical surgery where organ function allows, with radiotherapy as an alternative or adjunct; sentinel node assessment; systemic therapy as on the mucosal melanoma page (checkpoint inhibitors, BRAF and MEK inhibitors for BRAF V600, imatinib for KIT), with trials recommended (Cancer 2017).

## Fields

- Kind: Cancer
- Last checked: 2026-09-24
- Also known as: Primary vaginal melanoma; Melanoma of the vagina; Vulvovaginal melanoma (with vulvar melanoma)
- Tags: subtype-page; wave4; rare
- Group: gynaecologic
- Burden: Very rare: 125 vaginal melanomas were diagnosed in the US SEER registries over 1992 to 2005, with a white to black incidence ratio of 1.02 to 1, far below the 13 to 17 to 1 of cutaneous melanoma (Melanoma Research 2010).
- Subtypes: Vaginal melanoma of the lower third (the usual site; vaginal bleeding); Vaginal melanoma involving the vulva or urethra (vulvovaginal melanoma); BRAF-mutated vaginal melanoma; Amelanotic vaginal melanoma (diagnostic pitfall)
- Biomarkers: Melanocytic markers (S100, SOX10, Melan-A, HMB45); Tumour thickness and depth of invasion; BRAF, KIT and NRAS mutation testing; Node and distant staging

## Sections of this record

The page is a hub with ten sections in reading order; large sections have their own page. The same plan as JSON: https://onco.cc/api/v1/cancers/vaginal-melanoma/sections.json

- Overview (on the hub): The TL;DR, the family this cancer belongs to, the organ, who gets it and what the state of the art is. https://onco.cc/cancers/vaginal-melanoma/#overview
- What it is (on the hub): Anatomy, the subtypes and how they differ, how it is staged, and where advanced disease spreads. https://onco.cc/cancers/vaginal-melanoma/#what-it-is [4 subtypes]
- Finding it (on the hub): How it shows itself, how it is confirmed, what screening exists, and the biomarkers clinicians test for. https://onco.cc/cancers/vaginal-melanoma/#finding-it [4 biomarkers]
- Treating it (on the hub): The standard of care by setting, the medicines, surgery and radiotherapy named in it, and the regimens behind them. https://onco.cc/cancers/vaginal-melanoma/#treating-it [1 setting, 1 decision with options]
- Evidence (on the hub): Trials recruiting now, the landmark trials, the key papers and what they mean, the latest literature, and the milestones year by year. https://onco.cc/cancers/vaginal-melanoma/#evidence
- The science (on the hub): The molecular landscape: the targets and how often each appears, the pathways, the mechanics stages and the preclinical models. https://onco.cc/cancers/vaginal-melanoma/#science [3 targets]
- Where you are (own page): Cases by country, the UK and NHS pathway and other country lenses, and the expert centres with trials on record. https://onco.cc/cancers/vaginal-melanoma/where-you-are/
- Living with it (on the hub): The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask. https://onco.cc/cancers/vaginal-melanoma/#living-with-it [8 questions, 5 red cards]
- What is coming (own page): Everything in development, the open problems and what is being done about them, the roadmaps, and what changed on this record. https://onco.cc/cancers/vaginal-melanoma/coming/ [3 medicines]
- Data (own page): Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked. https://onco.cc/cancers/vaginal-melanoma/data/ [12 connected records]

## Standard of care

- All stages: Excision or radical surgery where feasible, radiotherapy as an alternative or adjunct; systemic therapy as on the mucosal melanoma page; trials recommended. ([Vaginal cancer](https://onco.cc/cancers/vaginal/), [Mucosal melanoma](https://onco.cc/cancers/mucosal-melanoma/), [Nivolumab](https://onco.cc/drugs/nivolumab/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/), [Imatinib](https://onco.cc/drugs/imatinib/))

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Vaginal_cancer
- NCI PDQ: vaginal cancer treatment: https://www.cancer.gov/types/vaginal/patient/vaginal-treatment-pdq
- Melanoma Research 2010: population-based incidence of vulvar and vaginal melanoma by race and ethnicity, SEER 1992 to 2005: https://doi.org/10.1097/cmr.0b013e32833684e8
- Cancer 2017: vulvar and vaginal melanoma, molecular analysis of 51 cases against 2,253 non-gynaecological melanomas: https://doi.org/10.1002/cncr.30473

## Connected records

- cancers: [Melanoma](https://onco.cc/cancers/melanoma/), [Mucosal melanoma](https://onco.cc/cancers/mucosal-melanoma/), [Vaginal cancer](https://onco.cc/cancers/vaginal/), [Vaginal squamous cell carcinoma (HPV-associated)](https://onco.cc/cancers/vaginal-squamous-cell-carcinoma/), [Vulvar melanoma](https://onco.cc/cancers/vulvar-melanoma/)
- targets: [BRAF](https://onco.cc/targets/braf/), [KIT](https://onco.cc/targets/kit/)
- drugs: [Imatinib](https://onco.cc/drugs/imatinib/), [Nivolumab](https://onco.cc/drugs/nivolumab/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/)

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JSON: https://onco.cc/api/v1/entities/vaginal-melanoma.json