Abstract
Vaginal melanoma (VM) is a very rare sort of primary vaginal cancer, accounting for very few malignant vaginal diseases, and even less of all types of melanomas. It is a highly aggressive and progressive tumor, with high rates of recurrence and metastasis. We report the case of an 83-year-old woman who presented with abnormal uterine bleeding and was ultimately diagnosed with primary vaginal mucosal melanoma. The case highlights the diagnostic difficulties, the importance of early biopsy and histopathology, including immunohistochemistry, and the challenges in systemic management for mucosal melanoma.