case_images: PMC9748561_01
case_images: Left: T2 Sagittal Image (A) and fat suppressed T2 Axial Image (C) of the Pelvis at baseline showing a hyperintense vaginal mass (asterisk) outlined by orange arrows. Right: T2 Sagittal Image of the Pelvis (B) and Axial Image of the Pelvis (D) 3 months following the initiation ipilimumab and nivolumab neoadjuvant therapy, where the hyperintense vaginal mass is no longer visualized.
case_images: fonc-12-1044587-g001.jpg
case_images: PMC9748561_03_fonc-12-1044587-g001.jpg
case_images: f1
case_images: This status persisted as imaged by PET/CT, transvaginal ultrasound and MRI imaging with continued follow-up up to 2 years;  Figure 1 .
case_images: Left: Histology slides at baseline showing neoplastic cells using SOX10 (A) and HMB45 (B) immunostains at 63X magnification. Right: Biopsy of tumor site displaying complete resolution of the tumor with no viable tumor cells and scar tissue formation as assessed 3 months following ipilimumab and nivolumab neoadjuvant therapy (C).
case_images: fonc-12-1044587-g002.jpg
case_images: PMC9748561_03_fonc-12-1044587-g002.jpg
case_images: f2
case_images: The patient underwent 12 circumferential vaginal biopsies shortly after the MRI, and all 12 biopsies showed no evidence of viable melanoma tumor cells, indicating a complete pathologic response (pCR) as illustrated in  Figure 2 .
case_images: PMC9748561_02
case_images: PMC9748561_03
case_images: Left: T2 Sagittal Image (A) and fat suppressed T2 Axial Image (C) of the Pelvis at baseline showing a hyperintense vaginal mass (asterisk) outlined by orange arrows. Right: T2 Sagittal Image of the Pelvis (B) and Axial Image of the Pelvis (D) 3 months following the initiation ipilimumab and nivolumab neoadjuvant therapy, where the hyperintense vaginal mass is no longer visualized.
case_images: fonc-12-1044587-g001.jpg
case_images: PMC9748561_03_fonc-12-1044587-g001.jpg
case_images: f1
case_images: This status persisted as imaged by PET/CT, transvaginal ultrasound and MRI imaging with continued follow-up up to 2 years;  Figure 1 .
case_images: Left: Histology slides at baseline showing neoplastic cells using SOX10 (A) and HMB45 (B) immunostains at 63X magnification. Right: Biopsy of tumor site displaying complete resolution of the tumor with no viable tumor cells and scar tissue formation as assessed 3 months following ipilimumab and nivolumab neoadjuvant therapy (C).
case_images: fonc-12-1044587-g002.jpg
case_images: PMC9748561_03_fonc-12-1044587-g002.jpg
case_images: f2
case_images: The patient underwent 12 circumferential vaginal biopsies shortly after the MRI, and all 12 biopsies showed no evidence of viable melanoma tumor cells, indicating a complete pathologic response (pCR) as illustrated in  Figure 2 .
case_images: Multiplex immunofluorescence immunohistochemistry of tumor biopsies at baseline (A, C) and at 3 months (B, D) following the initiation of ipilimumab and nivolumab showing changes in CD3 (green), CD8 (yellow), PD-L1 (orange), MHCI (cyan), SOX10 (cyan) and DAPI (blue) immunostains. A significant increase in the expression of MHC-I+/PD-L1+ (p=0.0286, 2-Tailed Mann-Whitney) and of CD3+/CD8+ (p=0.0286, 2-Tailed Mann-Whitney) was found at 3 months compared to baseline. *, It designates a p value lower than 0.05.
case_images: fonc-12-1044587-g003.jpg
case_images: PMC9748561_03_fonc-12-1044587-g003.jpg
case_images: f3
case_images: IHC results are presented in  Figure 3 .
case_images: Timeline with relevant data from the diagnosis.
case_images: fonc-12-1044587-g004.jpg
case_images: PMC9748561_03_fonc-12-1044587-g004.jpg
case_images: f4
case_images: A timeline with relevant data from the time of diagnosis is summarized in  Figure 4 .