Figure 1. Preoperative examinations: (A) Internal examination showed a 20×20 mm black and flat lesion on the posterior vaginal wall. (B) T2-weighted magnetic resonance imaging revealed no vaginal or uterus cervix mass. (C) Pap ×100. Vaginal cytology showed atypical cells with nuclear pleomorphisms and melanin production. (D) Immunohistochemical staining of vaginal cytology cell blocks showed the tumor cells were positive for melan-A.