{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:16:07Z","timestamp":1790007367112,"version":"4.0.1"},"reference-count":115,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T00:00:00Z","timestamp":1677715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>Primary malignant melanoma (MM) of the cervix uteri is a rare and aggressive malignancy of the female reproductive tract. Considering that clinical data on this cancer are scarce, we aimed to comprehensively examine the currently available literature and provide an overview of the reported cases of cervical MM focusing on the clinical characteristics, diagnosis and therapeutic management. We conducted a systematic review of the literature by screening three electronic databases until June 2022. The critical appraisal checklist provided by the Joanna Briggs Institute was employed to evaluate the overall quality of the studies. We included 96 reports, which comprised 137 patients diagnosed with MM of the cervix. The mean age of the patients was 56.5 (median: 58, age range: 33\u201388). Data regarding menopausal status were provided for 98 patients with 15 being premenopausal and 83 being postmenopausal. The most common presenting symptom was vaginal bleeding (83%, 100\/121). Biopsy (either excisional or punch biopsy) was used as the first diagnostic modality in most of the patients (67%, 64\/95), followed by cytology (18%, 17\/95). In 74 cases, the FIGO staging system for cervical cancer was used with the most common stage being FIGO stage I (38%, 28\/74), followed by FIGO stage II (36%, 27\/74), FIGO stage III (19%, 14\/74) and FIGO stage IV (7%, 5\/74). Most of the patients were managed surgically (90%, 119\/131) with a hysterectomy (either radical or total), and a salpingo-oophorectomy with\/without lymphadenectomy was the most common approach utilized (40%, 48\/119). The data of clinical outcomes were provided for 105 patients, of whom 61 died (58%, 61\/105) and 44 survived (42%, 44\/105). Knowledge regarding the rare occurrence of MM in the cervix and the increased awareness of clinicians can prevent clinical misdiagnosis and ultimately improve further the clinical outcomes of patients developing this rare malignancy.<\/jats:p>","DOI":"10.3390\/biology12030398","type":"journal-article","created":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T02:03:08Z","timestamp":1677808988000},"page":"398","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Primary Melanoma of the Cervix Uteri: A Systematic Review and Meta-Analysis of the Reported Cases"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6681-8479","authenticated-orcid":false,"given":"Konstantinos S.","family":"Kechagias","sequence":"first","affiliation":[{"name":"Society of Meta-Research and Biomedical Innovation, London W12 0FD, UK"},{"name":"Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London SW7 2BX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3633-7564","authenticated-orcid":false,"given":"Marina","family":"Zafeiri","sequence":"additional","affiliation":[{"name":"Society of Meta-Research and Biomedical Innovation, London W12 0FD, UK"},{"name":"King\u2019s College Hospital NHS Foundation Trust, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3858-4473","authenticated-orcid":false,"given":"Konstantinos","family":"Katsikas Triantafyllidis","sequence":"additional","affiliation":[{"name":"Society of Meta-Research and Biomedical Innovation, London W12 0FD, UK"},{"name":"Department of Nutrition and Dietetics, Royal Marsden Hospital, London SW3 6JJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Kyrtsonis","sequence":"additional","affiliation":[{"name":"Society of Meta-Research and Biomedical Innovation, London W12 0FD, UK"},{"name":"Department of General Surgery, Croydon University Hospital, Croydon, London CR7 7YE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Geropoulos","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University College London Hospitals, London NW1 2BU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deirdre","family":"Lyons","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London W2 1NY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Burney Ellis","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London SW7 2BX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Bowden","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London SW7 2BX, UK"},{"name":"Imperial College Healthcare NHS Trust, London W2 1NY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apostolia","family":"Galani","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London SW7 2BX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Paraskevaidi","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London SW7 2BX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Kyrgiou","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London SW7 2BX, UK"},{"name":"Imperial College Healthcare NHS Trust, London W2 1NY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,2]]},"reference":[{"key":"ref_1","first-page":"739","article-title":"Primary mucosal melanomas: A comprehensive review","volume":"5","author":"Mihajlovic","year":"2012","journal-title":"Int. J. Clin. Exp. Pathol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1016\/j.jaad.2006.06.017","article-title":"Primary mucosal melanoma","volume":"56","author":"Patrick","year":"2007","journal-title":"J. Am. Acad. Derm."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"15003","DOI":"10.1038\/nrdp.2015.3","article-title":"Melanoma","volume":"1","author":"Schadendorf","year":"2015","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1097\/CMR.0b013e328334c39a","article-title":"Primary malignant melanoma at unusual sites: An institutional experience with review of literature","volume":"20","author":"Das","year":"2010","journal-title":"Melanoma Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1089\/gyn.2018.0005","article-title":"Multidisciplinary Approach in the Management of Primary Malignant Melanoma of the Uterine Cervix: Diagnostic and Management Challenges","volume":"34","author":"Tranoulis","year":"2018","journal-title":"J. Gynecol. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.ygyno.2017.08.023","article-title":"Gynecologic melanomas: A clinicopathologic and molecular analysis","volume":"147","author":"Udager","year":"2017","journal-title":"Gynecol. Oncol."},{"key":"ref_7","first-page":"351","article-title":"Primary malignant melanoma of uterine cervix: A suggestion of new scheme of treatment combination","volume":"26","author":"Min","year":"2014","journal-title":"Chin. J. Cancer Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/S1470-2045(08)70254-7","article-title":"Management of primary melanoma of the female urogenital tract","volume":"9","author":"Piura","year":"2008","journal-title":"Lancet Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"913964","DOI":"10.3389\/fonc.2022.913964","article-title":"Primary Malignant Melanoma of the Cervix: An Integrated Analysis of Case Reports and Series","volume":"12","author":"Min","year":"2022","journal-title":"Front. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e94","DOI":"10.3802\/jgo.2019.30.e94","article-title":"Investigating the role of immunotherapy in advanced\/recurrent female genital tract melanoma: A preliminary experience","volume":"30","author":"Indini","year":"2019","journal-title":"J. Gynecol. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"g7647","DOI":"10.1136\/bmj.g7647","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: Elaboration and explanation","volume":"349","author":"Shamseer","year":"2015","journal-title":"BMJ"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3892\/mco.2022.2496","article-title":"Recurrent malignant melanoma of the uterine cervix treated with anti-PD-1 antibodies and anti-CTLA-4 antibodies: A case report","volume":"16","author":"Sone","year":"2022","journal-title":"Mol. Clin. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1111\/cyt.13048","article-title":"Smear detected cervicovaginal melanoma following negative screening-a cautionary tale of rapidly developing malignancy of the lower female genital tract","volume":"32","author":"Ng","year":"2021","journal-title":"Cytopathology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1007\/s13691-021-00477-z","article-title":"Primary malignant melanoma of uterine cervix treated with pembrolizumab as adjuvant immunotherapy","volume":"10","author":"Suzuki","year":"2021","journal-title":"Int. Cancer Conf. J."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Cai, Y.J., Ke, L.F., Zhang, W.W., Lu, J.P., and Chen, Y.P. (2021). Recurrent KRAS, KIT and SF3B1 mutations in melanoma of the female genital tract. BMC Cancer, 21.","DOI":"10.1186\/s12885-021-08427-x"},{"key":"ref_16","first-page":"7206786","article-title":"Primary Malignant Melanoma of the Cervix: A Case Report and a Review of the Literature","volume":"2020","author":"Diakosavvas","year":"2020","journal-title":"Case Rep. Oncol. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1002\/ccr3.2928","article-title":"Management of a primary malignant melanoma of uterine cervix stage IVA patient with radical surgery and adjuvant oncolytic virus Rigvir((R)) therapy: A case report","volume":"8","author":"Pumpure","year":"2020","journal-title":"Clin. Case Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1111\/jog.14136","article-title":"Primary malignant melanoma of the uterine cervix or vagina which were successfully treated with nivolumab","volume":"46","author":"Anko","year":"2020","journal-title":"J. Obs. Gynaecol. Res."},{"key":"ref_19","first-page":"e8484","article-title":"Malignant Melanoma of the Female Genital Tract: Experience of an Oncology Center in Pakistan","volume":"12","author":"Shakeel","year":"2020","journal-title":"Cureus"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e16366","DOI":"10.1097\/MD.0000000000016366","article-title":"Primary malignant melanoma of the female genital tract synchronously involving the vulva and uterine cervix: A case report","volume":"98","author":"Pang","year":"2019","journal-title":"Medicine"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/PGP.0000000000000480","article-title":"Primary Cervical Malignant Melanoma: 2 Cases and a Literature Review","volume":"38","author":"Yin","year":"2019","journal-title":"Int. J. Gynecol. Pathol."},{"key":"ref_22","first-page":"1317","article-title":"Blue nevus-like melanoma of the uterine cervix. Case report and review of the literature","volume":"60","author":"Eniu","year":"2019","journal-title":"Rom. J. Morphol. Embryol."},{"key":"ref_23","first-page":"224723","article-title":"Primary amelanotic malignant melanoma of cervix masquerading as squamous cell carcinoma presenting with extensive metastases","volume":"2018","author":"Srivastava","year":"2018","journal-title":"BMJ Case Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1097\/CMR.0000000000000469","article-title":"Primary malignant melanoma of the cervix: 14 cases and literature overview","volume":"28","author":"Sun","year":"2018","journal-title":"Melanoma Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"524","DOI":"10.5468\/ogs.2018.61.4.524","article-title":"Primary malignant melanoma of the uterine cervix treated with pembrolizumab after radical surgery: A case report and literature review","volume":"61","author":"Kim","year":"2018","journal-title":"Obs. Gynecol. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1055\/s-0038-1624578","article-title":"Postpartum Genital Melanoma\u2014A Case Report","volume":"40","author":"Nai","year":"2018","journal-title":"Rev. Bras. Ginecol. Obs."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"73162","DOI":"10.18632\/oncotarget.17183","article-title":"Primary malignant melanoma of the cervix: Report of 14 cases and review of literature","volume":"8","author":"Yuan","year":"2017","journal-title":"Oncotarget"},{"key":"ref_28","first-page":"219361","article-title":"Primary malignant melanoma of the cervix: A rare disease","volume":"2017","author":"Juliao","year":"2017","journal-title":"BMJ Case Rep."},{"key":"ref_29","first-page":"5656340","article-title":"A Case of Malignant Melanoma of the Uterine Cervix with Disseminated Metastases throughout the Vaginal Wall","volume":"2017","author":"Noguchi","year":"2017","journal-title":"Case Rep. Obs. Gynecol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1097\/LGT.0000000000000264","article-title":"Primary Melanoma of the Uterine Cervix: A Case Report, With Key Points on Recognition and Pathological Diagnosis","volume":"21","author":"Lim","year":"2017","journal-title":"J. Low Genit. Tract. Dis."},{"key":"ref_31","first-page":"217970","article-title":"Malignant melanoma of cervix","volume":"2016","author":"Gupta","year":"2016","journal-title":"BMJ Case Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"415","DOI":"10.5468\/ogs.2016.59.5.415","article-title":"Primary malignant melanoma of cervix and vagina","volume":"59","author":"Lee","year":"2016","journal-title":"Obs. Gynecol. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1002\/dc.23471","article-title":"Amelanotic malignant melanoma of the uterine cervix diagnosed by cervical smear","volume":"44","author":"Arik","year":"2016","journal-title":"Diagn. Cytopathol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1007\/s00404-016-4144-4","article-title":"Genital melanoma: Prognosis factors and treatment modality","volume":"294","author":"Ferraioli","year":"2016","journal-title":"Arch Gynecol. Obs."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.gore.2016.04.001","article-title":"Combined immunotherapy and radiation for treatment of mucosal melanomas of the lower genital tract","volume":"16","author":"Schiavone","year":"2016","journal-title":"Gynecol. Oncol. Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.gore.2015.01.003","article-title":"Primary gynecologic melanoma: A report of two unusual cases","volume":"11","author":"Berger","year":"2015","journal-title":"Gynecol. Oncol. Rep."},{"key":"ref_37","first-page":"958756","article-title":"Biatrial Cardiac Metastases in a Patient with Uterine Cervix Malignant Melanoma","volume":"2015","author":"Geredeli","year":"2015","journal-title":"Case Rep. Cardiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e147","DOI":"10.5301\/tj.5000304","article-title":"Primary mucosal malignant melanoma of the cervix: Case report and review of the literature","volume":"101","author":"Cetinkaya","year":"2015","journal-title":"Tumori"},{"key":"ref_39","first-page":"607","article-title":"Primary malignant melanoma of the cervix: A case report","volume":"36","author":"Mihmanli","year":"2015","journal-title":"Eur. J. Gynaecol. Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1007\/s13224-013-0437-8","article-title":"Primary malignant melanoma of uterine cervix","volume":"64","author":"Bhargava","year":"2014","journal-title":"J. Obs. Gynaecol. India"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2661","DOI":"10.3892\/ol.2014.2555","article-title":"Primary malignant melanoma of the cervix: A case report","volume":"8","author":"Liu","year":"2014","journal-title":"Oncol. Lett."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"111","DOI":"10.3109\/01443615.2013.834297","article-title":"Primary malignant melanoma of uterine cervix","volume":"34","author":"Omranipour","year":"2014","journal-title":"J. Obs. Gynaecol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1177\/1066896914531817","article-title":"Melanoma with rhabdomyosarcomatous differentiation: Two further cases of a rare pathologic pitfall","volume":"22","author":"Shenjere","year":"2014","journal-title":"Int. J. Surg. Pathol."},{"key":"ref_44","first-page":"41","article-title":"Sarcomatoid carcinoma of the cervix with foci of malignant melanoma","volume":"5","author":"Shrivastava","year":"2014","journal-title":"J. Midlife Health"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.gynor.2013.04.004","article-title":"Primary malignant melanoma of uterine cervix FIGO IIa1: A case report with 40 months ongoing survival and literature review","volume":"5","author":"Myriokefalitaki","year":"2013","journal-title":"Gynecol. Oncol. Case Rep."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"bcr2013010042","DOI":"10.1136\/bcr-2013-010042","article-title":"Primary malignant melanoma of uterine cervix with probable origin from benign cervical melanosis","volume":"2013","author":"Singh","year":"2013","journal-title":"BMJ Case Rep."},{"key":"ref_47","first-page":"58","article-title":"The primary melanoma of the female genital tract: Report of three cases and review of literature","volume":"16","author":"Bennani","year":"2013","journal-title":"Pan. Afr. Med. J."},{"key":"ref_48","first-page":"986542","article-title":"Coexisting malignant melanoma and blue nevus of the uterine cervix: An unusual combination","volume":"2012","author":"Parada","year":"2012","journal-title":"Case Rep. Pathol."},{"key":"ref_49","first-page":"120026","article-title":"Uterine cervical melanoma presenting with rapid progression detected by PET\/CT","volume":"1","author":"Tsai","year":"2012","journal-title":"Acta Radiol. Short Rep."},{"key":"ref_50","first-page":"683020","article-title":"Primary malignant melanoma of the uterine cervix treated with ultraradical surgery: A case report","volume":"2011","author":"Villavicencio","year":"2011","journal-title":"ISRN Obs. Gynecol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"508.e1","DOI":"10.1016\/j.ajog.2011.09.016","article-title":"A peculiar site: Melanoma of the cervix","volume":"205","author":"Zhang","year":"2011","journal-title":"Am. J. Obs. Gynecol."},{"key":"ref_52","first-page":"448","article-title":"Primary malignant melanoma of the uterine cervix--case report and review","volume":"32","author":"Simoes","year":"2011","journal-title":"Eur. J. Gynaecol. Oncol."},{"key":"ref_53","first-page":"25","article-title":"Cytomorphology of cervicovaginal melanoma: ThinPrep versus conventional Papanicolaou tests","volume":"7","author":"Setia","year":"2010","journal-title":"Cytojournal"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"199","DOI":"10.3802\/jgo.2010.21.3.199","article-title":"Primary amelanotic melanoma of the cervix: Case report with review of literature","volume":"21","author":"Duggal","year":"2010","journal-title":"J. Gynecol. Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"575","DOI":"10.4103\/0377-4929.56164","article-title":"Primary malignant melanoma of the uterine cervix","volume":"52","author":"Khurana","year":"2009","journal-title":"Indian J. Pathol. Microbiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1097\/CMR.0b013e32831993de","article-title":"Primary malignant amelanotic melanoma of the female genital tract: Report of two cases and review of literature","volume":"19","author":"An","year":"2009","journal-title":"Melanoma Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1007\/s00404-008-0912-0","article-title":"A rare case of primary malignant melanoma of cervix","volume":"280","author":"Baruah","year":"2009","journal-title":"Arch Gynecol. Obs."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1007\/s00404-008-0761-x","article-title":"Primary malignant melanoma of the cervix: Report of a case","volume":"279","author":"Yucesoy","year":"2009","journal-title":"Arch Gynecol. Obs."},{"key":"ref_59","first-page":"106","article-title":"Amelanotic malignant melanoma of the uterine cervix with ten-year follow-up","volume":"30","author":"Mandato","year":"2009","journal-title":"Eur. J. Gynaecol. Oncol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1097\/PGP.0b013e31817323c4","article-title":"Primary uterine cervix melanoma resembling malignant peripheral nerve sheath tumor: A case report","volume":"27","author":"Pusceddu","year":"2008","journal-title":"Int. J. Gynecol. Pathol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1159\/000325690","article-title":"Primary melanoma of the uterine cervix after supracervical hysterectomy. A case report","volume":"51","author":"Jin","year":"2007","journal-title":"Acta Cytol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1097\/01.lgt.0000229564.11741.4e","article-title":"Primary malignant melanoma of the uterine cervix: Case report and review of the literature","volume":"10","author":"Mousavi","year":"2006","journal-title":"J. Low Genit. Tract. Dis."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.ejogrb.2005.06.024","article-title":"Malignant melanoma of the uterine cervix","volume":"124","author":"Wydra","year":"2006","journal-title":"Eur. J. Obs. Gynecol. Reprod. Biol."},{"key":"ref_64","first-page":"257","article-title":"Clinical analysis of primary malignant melanoma of the cervix","volume":"20","author":"Ma","year":"2005","journal-title":"Chin. Med. Sci. J."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"201","DOI":"10.4103\/0019-509X.19206","article-title":"Primary malignant melanoma of cervix\u2014A case report","volume":"42","author":"Gupta","year":"2005","journal-title":"Indian J. Cancer"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1080\/01443610500338305","article-title":"Malignant melanoma of the uterine cervix","volume":"25","author":"Siozos","year":"2005","journal-title":"J. Obs. Gynaecol."},{"key":"ref_67","first-page":"257","article-title":"Primary malignant melanoma of cervix: A case report","volume":"47","author":"Kudrimoti","year":"2004","journal-title":"Indian J. Pathol. Microbiol."},{"key":"ref_68","first-page":"1063","article-title":"Primary malignant melanoma of the cervix uteri: A case report of a rare tumor","volume":"23","author":"Makovitzky","year":"2003","journal-title":"Anticancer Res."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1007\/s00292-002-0596-3","article-title":"Primary malignant melanoma of the uterine cervix. Report of two cases and review of the literature","volume":"24","author":"Boldt","year":"2003","journal-title":"Pathologe"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1046\/j.1365-2303.2003.00014.x","article-title":"Primary malignant melanoma of uterine cervix: A rare entity diagnosed on fine needle aspiration cytology--report of a case","volume":"14","author":"Gupta","year":"2003","journal-title":"Cytopathology"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1002\/dc.2014","article-title":"Primary malignant melanoma of the uterine cervix: Report of a case diagnosed by cervical scrape cytology and review of the literature","volume":"25","author":"Deshpande","year":"2001","journal-title":"Diagn. Cytopathol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/S1297-9589(01)00148-5","article-title":"Primary malignant melanoma of the cervix uteri: Apropos of 1 case with review of the literature","volume":"29","author":"Zamiati","year":"2001","journal-title":"Gynecol. Obs. Fertil."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1006\/gyno.2000.6091","article-title":"Clear cell variant of malignant melanoma of the uterine cervix: A case report and review of the literature","volume":"80","author":"Furuya","year":"2001","journal-title":"Gynecol. Oncol."},{"key":"ref_74","first-page":"234","article-title":"Radiation-induced malignant melanoma of the cervix","volume":"12","author":"Benson","year":"2000","journal-title":"Clin. Oncol. (R Coll Radiol.)"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1080\/01443619964094","article-title":"Primary malignant melanoma of the cervix uteri","volume":"19","author":"Wasef","year":"1999","journal-title":"J. Obs. Gynaecol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1097\/00004347-199907000-00013","article-title":"Primary malignant melanoma of the uterine cervix: Case report with world literature review","volume":"18","author":"Clark","year":"1999","journal-title":"Int. J. Gynecol. Pathol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1006\/gyno.1999.5491","article-title":"Primary malignant melanoma of the uterine cervix: Case report and review of the literature","volume":"75","author":"Cantuaria","year":"1999","journal-title":"Gynecol. Oncol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/j.1447-0756.1999.tb01134.x","article-title":"Primary malignant melanoma of the uterine cervix: A case report","volume":"25","author":"Takehara","year":"1999","journal-title":"J. Obs. Gynaecol. Res."},{"key":"ref_79","first-page":"1043","article-title":"Malignant melanoma of the uterine cervix diagnosed on a cervical cytologic smear","volume":"42","author":"Schlosshauer","year":"1998","journal-title":"Acta Cytol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1590\/S1516-31801998000400007","article-title":"Primary melanoma of the uterine cervix figo stage III B","volume":"116","author":"Teixeira","year":"1998","journal-title":"Sao Paulo Med. J."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1046\/j.1365-2559.1998.0415h.x","article-title":"Desmoplastic malignant melanoma of the uterine cervix: A rare primary malignancy in the uterus mimicking a sarcoma","volume":"33","author":"Ishikura","year":"1998","journal-title":"Histopathology"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1111\/j.1447-0756.1997.tb00880.x","article-title":"Malignant melanoma of the uterine cervix: A case report","volume":"23","author":"Miyagi","year":"1997","journal-title":"J. Obs. Gynaecol. Res."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1111\/j.1365-2133.1996.tb03908.x","article-title":"Primary malignant melanomas of cervix uteri and vulva","volume":"135","author":"Butt","year":"1996","journal-title":"Br. J. Derm."},{"key":"ref_84","first-page":"65","article-title":"Primary melanoma of the cervix. A case report","volume":"38","author":"Fleming","year":"1994","journal-title":"Acta Cytol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/S0009-9260(05)81241-3","article-title":"MR findings of malignant melanoma of the vagina","volume":"48","author":"Moon","year":"1993","journal-title":"Clin. Radiol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1159\/000271977","article-title":"Case report of primary irradiated melanoma of the cervix uteri","volume":"32","author":"Joura","year":"1992","journal-title":"Gynakol. Geburtshilfliche Rundsch"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/0090-8258(92)90148-C","article-title":"Primary malignant melanoma of the cervix and review of the literature","volume":"47","author":"Kristiansen","year":"1992","journal-title":"Gynecol. Oncol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"312","DOI":"10.3109\/00313029109063595","article-title":"Malignant melanoma of the female genital tract. A report of nine cases in the Chinese of Hong Kong","volume":"23","author":"Khoo","year":"1991","journal-title":"Pathology"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1159\/000293117","article-title":"Primary malignant melanoma of the uterine cervix: Case report and review of the literature","volume":"31","author":"Pinedo","year":"1991","journal-title":"Gynecol. Obs. Invest."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1097\/00006254-199011000-00003","article-title":"Primary malignant melanoma of the uterine cervix: Two case reports and a century\u2019s review","volume":"45","author":"Santoso","year":"1990","journal-title":"Obs. Gynecol. Surv."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"259","DOI":"10.3109\/00016349009028690","article-title":"Primary melanoma of the cervix uteri, an avis rara? A review of the literature","volume":"69","author":"Vleugels","year":"1990","journal-title":"Acta Obs. Gynecol. Scand."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/0090-8258(90)90380-4","article-title":"A patient with multiple, malignant melanomas of the lower genital tract","volume":"37","author":"Podczaski","year":"1990","journal-title":"Gynecol. Oncol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1159\/000293632","article-title":"Malignant melanoma of the cervix","volume":"27","author":"Chua","year":"1989","journal-title":"Gynecol. Obs. Invest."},{"key":"ref_94","first-page":"252","article-title":"Malignant melanoma of the cervix. Report of a case","volume":"32","author":"Holmquist","year":"1988","journal-title":"Acta Cytol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/S0009-9260(88)80565-8","article-title":"Primary malignant melanoma of the uterine cervix","volume":"39","author":"Owens","year":"1988","journal-title":"Clin. Radiol."},{"key":"ref_96","first-page":"73","article-title":"Detection of malignant melanoma of the uterine cervix from Papanicolaou smears. A case report","volume":"31","author":"Yu","year":"1987","journal-title":"Acta Cytol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1111\/j.1471-0528.1986.tb07820.x","article-title":"Primary malignant melanoma of the cervix. Case report","volume":"93","author":"Krishnamoorthy","year":"1986","journal-title":"Br. J. Obs. Gynaecol."},{"key":"ref_98","first-page":"1149","article-title":"Primary melanoma of the cervix: Report of a case","volume":"73","author":"Ramsey","year":"1981","journal-title":"J. Natl. Med. Assoc."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1111\/j.1471-0528.1981.tb01208.x","article-title":"Primary malignant melanoma of the cervix. Case report","volume":"88","author":"Mudge","year":"1981","journal-title":"Br. J. Obs. Gynaecol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/BF00431080","article-title":"Primary malignant melanoma of the vagina and cervix uteri. Report of a case with ultrastructural study","volume":"393","author":"Genton","year":"1981","journal-title":"Virchows Arch. A Pathol. Anat. Histol."},{"key":"ref_101","first-page":"525","article-title":"Primary malignant melanoma of the uterine cervix","volume":"56","author":"Hall","year":"1980","journal-title":"Obs. Gynecol."},{"key":"ref_102","first-page":"459","article-title":"Malignant melanoma of the cervix uteri","volume":"47","author":"Puri","year":"1976","journal-title":"Obs. Gynecol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/0002-9378(71)90953-7","article-title":"A primary melanocarcinoma of the cervix","volume":"111","author":"Jones","year":"1971","journal-title":"Am. J. Obs. Gynecol."},{"key":"ref_104","first-page":"257","article-title":"A case of melanoma of the cervix","volume":"57","author":"Evers","year":"1950","journal-title":"J. Obs. Gynaecol. Br. Emp."},{"key":"ref_105","first-page":"617","article-title":"Melanoid pigmentation of the endocervix: A neurogenic visceral argument","volume":"4","author":"Cid","year":"1959","journal-title":"Ann. Anat. Pathol. (Paris)"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/S0046-8177(85)80217-3","article-title":"Blue nevus of the uterine cervix","volume":"16","author":"Patel","year":"1985","journal-title":"Hum. Pathol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.critrevonc.2011.03.008","article-title":"A literature overview of primary cervical malignant melanoma: An exceedingly rare cancer","volume":"81","author":"Pusceddu","year":"2012","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1093\/ajcp\/46.4.420","article-title":"Melanomas of the Vagina","volume":"46","author":"Norms","year":"1966","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"e070135","DOI":"10.1136\/bmj-2022-070135","article-title":"Role of human papillomavirus (HPV) vaccination on HPV infection and recurrence of HPV related disease after local surgical treatment: Systematic review and meta-analysis","volume":"378","author":"Kechagias","year":"2022","journal-title":"BMJ"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"4799","DOI":"10.3389\/fonc.2021.779042","article-title":"PCNA in Cervical Intraepithelial Neoplasia and Cervical Cancer: An Interaction Network Analysis of Differentially Expressed Genes","volume":"11","author":"Giannos","year":"2021","journal-title":"Front. Oncol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.bpobgyn.2021.05.007","article-title":"Morbidity after local excision of the transformation zone for cervical intra-epithelial neoplasia and early cervical cancer","volume":"75","author":"Kyrgiou","year":"2021","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"e83","DOI":"10.1016\/j.ejogrb.2021.11.275","article-title":"280 Environmental and modifiable risk factors for cervical cancer: An umbrella review","volume":"270","author":"Doulgeraki","year":"2022","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1111\/j.1600-0625.2009.00866.x","article-title":"Detection of alpha-and beta-human papillomavirus (HPV) in cutaneous melanoma: A matched and controlled study using specific multiplex PCR combined with DNA microarray primer extension","volume":"18","author":"Ruer","year":"2009","journal-title":"Exp. Dermatol."},{"key":"ref_114","first-page":"4017","article-title":"Primary malignant melanomas of the female lower genital tract: Clinicopathological characteristics and management","volume":"10","author":"Wang","year":"2020","journal-title":"Am. J. Cancer Res."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1177\/1758834017708742","article-title":"Pembrolizumab in cervical cancer: Latest evidence and clinical usefulness","volume":"9","author":"Borcoman","year":"2017","journal-title":"Ther. Adv. Med. Oncol."}],"container-title":["Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-7737\/12\/3\/398\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:46:38Z","timestamp":1760121998000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-7737\/12\/3\/398"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,2]]},"references-count":115,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["biology12030398"],"URL":"https:\/\/doi.org\/10.3390\/biology12030398","relation":{},"ISSN":["2079-7737"],"issn-type":[{"value":"2079-7737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,2]]}}}