Vaginal mucosal melanoma recurrence with intracardiac metastasis treated with immunotherapy

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Vaginal mucosal melanoma with intracardiac metastasis (n=1). Intervention: Surgical resection and adjuvant immunotherapy (ipilimumab and nivolumab). Primary outcome: Survival and disease control.

Q: What does this research mean for the field?

Primary surgical resection followed by combination immunotherapy with ipilimumab and nivolumab can achieve a partial response and prolonged disease control in patients with intracardiac metastasis from vaginal mucosal melanoma. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Janvi Singh; Daniel Chen; Melvin Chin; Lyndal Anderson; Rhonda Farrell

doi:10.1016/j.gore.2026.102060

March 1, 2026Gynecologic Oncology ReportsOpen Access

Vaginal mucosal melanoma recurrence with intracardiac metastasis treated with immunotherapy

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Key result

Surgery followed by dual immunotherapy yields 3-year survival in intracardiac metastatic vaginal melanoma.

n=1

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Why the study?

Vaginal mucosal melanoma is a rare, highly malignant tumour without guideline-informed therapy, and no prior cases of metastasis to the heart have been reported.

Key Points

To describe the clinical management and treatment outcomes of a rare presentation of recurrent vaginal mucosal melanoma metastasizing to intracardiac tissue.
Evaluated a 54-year-old woman presenting with vaginal mucosal melanoma with subsequent intracardiac and peritoneal metastases harboring a BRAF L597R mutation.
Administered primary surgical excision followed by combination immune checkpoint inhibitors (ipilimumab and nivolumab) initiated in a coronary care unit.
Monitored cardiac safety and disease progression using 24/7 telemetry, serial transthoracic echocardiography, cardiac-focused MRI, and surveillance PET CT scans.
Primary surgical resection combined with adjuvant immunotherapy achieved successful disease control, with the patient demonstrating a partial response at 3 years of follow-up.
Continuous cardiac telemetry and multimodal imaging in the coronary care unit confirmed no evidence of immune checkpoint inhibitor-mediated cardiotoxicity.
Treatment-related side effects occurred but were successfully managed with good clinical response.

Study Design

Type

Case Report (n=1)

Structured PICO

P

Population

A 54-year-old otherwise well female diagnosed with vaginal mucosal melanoma that metastasized to the heart, followed over a 3-year period.

I

Intervention

Primary surgical resection (nerve-sparing radical hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic sentinel node biopsies, and lymph node dissection) followed by dual immune checkpoint inhibitor therapy (ipilimumab and nivolumab), subsequently transitioned to nivolumab monotherapy every 4 weeks.

This case report highlights that intracardiac metastasis from vaginal mucosal melanoma can be stabilized using immunotherapy, guided by multidisciplinary input and multimodality imaging, despite significant immune-related adverse events.

Implication

May support resection plus dual checkpoint blockade for rare intracardiac vaginal melanoma metastases; leaves open generalizability from single-case evidence.

Abstract

• In depth review of treatment regime and disease control. • Multidisciplinary specialist input. • Clear description of factors influencing care and outcomes. Vaginal mucosal melanoma (VMM) is highly malignant tumour with limited cases reported worldwide. There are no guidelines in place to inform best therapy; instead, management is guided by previous studies and outcomes. There have been no reported cases of vaginal mucosal melanoma metastasizing to the heart. This case follows 54-year-old, otherwise well woman with VMM metastasizing to the heart. It outlines diagnosis, multi-specialty input, chosen treatments and progress of recovery and successful disease control. Primary surgical resection and adjuvant immunotherapy were best indicated and depicted best survival outcomes for this case. Multidisciplinary expert care is essential in clinical decision making. Immunotherapy significant improved survival, and side effects were able to be managed with good response.

Discussion

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Cite This Study

Singh et al. (2026) conducted a case report in Vaginal mucosal melanoma with intracardiac metastasis (n=1). Surgical resection and adjuvant immunotherapy (ipilimumab and nivolumab) was evaluated on Survival and disease control.

synapsesocial.com/papers/69be34af6e48c4981c672d6b https://doi.org/10.1016/j.gore.2026.102060

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Vaginal mucosal melanoma recurrence with intracardiac metastasis treated with immunotherapy

Figures

Key Points

Study Design

Structured PICO

Implication

Abstract

Discussion

Cite This Study

Vaginal mucosal melanoma recurrence with intracardiac metastasis treated with immunotherapy

Figures

Key Points

Study Design

Structured PICO

Implication

Abstract

Discussion

Cite This Study

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