{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T12:42:48Z","timestamp":1786711368524,"version":"build-2736575974"},"reference-count":22,"publisher":"Scientific Scholar","content-domain":{"domain":["cytojournal.com"],"crossmark-restriction":true},"short-container-title":["Cytojournal"],"abstract":"<jats:p>Malignant melanoma is a rare form of cancer in the Middle East, and its occurrence, particularly in the female genital tract, is exceptionally uncommon. These tumors often present diagnostic challenges due to their rarity and variable cytomorphological features. We report the case of a 61-year-old postmenopausal woman from a rural region who presented with vaginal bleeding. A routine Papanicolaou (Pap) smear revealed atypical pigmented malignant cells, raising suspicion for melanoma. Histopathological examination of a vaginal wall biopsy, supported by immunohistochemical staining, confirmed the diagnosis of malignant melanoma. The patient underwent total vaginectomy with labia minora resection. Post-operative positron emission tomography showed no residual or metastatic disease. She is currently receiving adjuvant nivolumab and is doing well. To the best of our knowledge, melanoma diagnosed through cervicovaginal Pap smear has been rarely documented in a Middle Eastern woman. This case underscores the critical role of cytological screening and the importance of a broad differential diagnosis for detecting rare malignancies, even in low-incidence regions.<\/jats:p>","DOI":"10.25259\/cytojournal_163_2025","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T12:39:03Z","timestamp":1786538343000},"page":"52","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Malignant melanoma of the female genital tract diagnosed by cervicovaginal smear: A rare case from the Middle East"],"prefix":"10.25259","volume":"23","author":[{"given":"Waleed","family":"Al Amri","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, The Royal Hospital, Muscat, Oman,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishaq","family":"Al Salmi","sequence":"additional","affiliation":[{"name":"Radiology, The Royal Hospital, Muscat, Oman,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasser","family":"Al Rahbi","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, The Royal Hospital, Muscat, Oman,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"10.25259\/Cytojournal_163_2025\/ref-1","doi-asserted-by":"publisher","first-page":"e2200338","DOI":"10.1200\/GO.22.00338","article-title":"Incidence trends of melanoma and nonmelanoma skin cancers in Jordan from 2000 to 2016","volume":"9","author":"Almaani","year":"2023","journal-title":"JCO Glob Oncol"},{"key":"10.25259\/Cytojournal_163_2025\/ref-2","doi-asserted-by":"publisher","first-page":"e2300337","DOI":"10.1200\/GO.23.00337","article-title":"Analyzing cancer incidence trends in Oman From 1996 to 2019: A comprehensive study of the National cancer annual reports","volume":"10","author":"Al-Sayegh","year":"2024","journal-title":"JCO Glob Oncol"},{"key":"10.25259\/Cytojournal_163_2025\/ref-3","first-page":"285","article-title":"Primary vaginal melanoma: A case report and literature review","volume":"29","author":"Schmidt","year":"2008","journal-title":"Eur J Gynaecol Oncol"},{"key":"10.25259\/Cytojournal_163_2025\/ref-4","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1002\/dc.24058","article-title":"Metastatic melanoma of the uterine cervix diagnosed on cervical Pap smear: Case report and literature review","volume":"46","author":"Shachner","year":"2018","journal-title":"Diagn Cytopathol"},{"key":"10.25259\/Cytojournal_163_2025\/ref-5","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1001\/jamadermatol.2022.0160","article-title":"Global burden of cutaneous melanoma in 2020 and projections to 2040","volume":"158","author":"Arnold","year":"2022","journal-title":"JAMA Dermatol"},{"key":"10.25259\/Cytojournal_163_2025\/ref-6","doi-asserted-by":"publisher","first-page":"15330338251336829","DOI":"10.1177\/15330338251336829","article-title":"Cancer genetics in the Arab world","volume":"24","author":"Al Amri","year":"2025","journal-title":"Technol Cancer Res Treat"},{"key":"10.25259\/Cytojournal_163_2025\/ref-7","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1002\/ijc.27616","article-title":"International trends in the incidence of malignant melanoma 1953-2008--are recent generations at higher or lower risk?","volume":"132","author":"Erdmann","year":"2013","journal-title":"Int J Cancer"},{"key":"10.25259\/Cytojournal_163_2025\/ref-8","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1097\/JD9.0000000000000253","article-title":"Perspective on melanoma in the Arab world: A quantitative and qualitative pubmed-based analysis of research output (2004-2019)","volume":"5","author":"Daou","year":"2022","journal-title":"Int J Dermatol Venereol"},{"key":"10.25259\/Cytojournal_163_2025\/ref-9","first-page":"405","article-title":"Cancer incidence in the middle Eastern population of California, 1988-2004","volume":"8","author":"Nasseri","year":"2007","journal-title":"Asian Pac J Cancer Prev"},{"key":"10.25259\/Cytojournal_163_2025\/ref-10","doi-asserted-by":"publisher","first-page":"AB229","DOI":"10.1016\/j.jaad.2024.07.911","article-title":"53288 identifying knowledge gaps in melanoma in middle Eastern and North African populations in the United States and in the middle East","volume":"91","author":"Sagman","year":"2024","journal-title":"J Am Acad Dermatol"},{"key":"10.25259\/Cytojournal_163_2025\/ref-11","doi-asserted-by":"publisher","first-page":"133","DOI":"10.21873\/invivo.11036","article-title":"Primary vaginal melanoma, a rare and aggressive entity. 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