Gynecologic melanomas are rare and have a poor prognosis. Although immunotherapy (immune checkpoint inhibitors) and targeted therapy has greatly improved the systemic treatment of cutaneous melanoma (CM) in recent years, its efficacy in gynecologic melanomas remains uncertain because of the rarity of this malignancy and its scarce literature. This review aimed to evaluate the literature of gynecologic melanomas treated with immunotherapy and targeted therapy through a PubMed search. We identified one study focusing on the overall survival of gynecologic melanomas separately and five case series and nine case reports concentrating on gynecologic melanomas treated with an immune checkpoint inhibitor and/or targeted therapy. Furthermore, the KIT mutation has the highest rate among all mutations in mucosal melanoma types. The KIT inhibitors (Tyrosine kinase inhibitors: TKIs) imatinib and nilotinib could be the treatment options. Moreover, immune checkpoint inhibitors combined with KIT inhibitors may potentially treat cases of resistance to immune checkpoint inhibitors. However, because of the different conditions and a small number of cases, it is difficult to evaluate the efficacy of immunotherapy and targeted therapy for gynecologic melanoma rigorously at this time. Further prospective cohort or randomized trials of gynecologic melanoma alone are needed to assess the treatment with solid evidence.

Objective: Chylous ascites (CA) is a rare yet clinically significant complication following gynecologic cancer surgery, with incidence rates of 0.17 % to 9%. We aimed to describe a case of CA with a delayed clinical presentation nearly 100 days postoperatively in a patient with advanced endometrial cancer and to review the management strategies. Methods: We retrospectively evaluated a 75‐year‐old patient who underwent radical hysterectomy, bilateral salpingo‐oophorectomy, extended lymphadenectomy (pelvic and para‐aortic), and partial omentectomy for stage IIIB endometrial cancer. Data collected included onset timing, ascitic fluid analysis, imaging findings, and treatment responses. Additionally, a narrative review identified 13 relevant studies discussing the onset, risk factors, diagnosis, and therapies for post‐operative CA in gynecologic oncology. Results: Although CA typically appears within 4 to 21 days, our patient developed CA at approximately post‐operative day 99. Diagnostic paracentesis confirmed triglyceride‐rich ascitic fluid, establishing the diagnosis of CA. Dietary modification (fasting followed by medium‐chain triglyceride diet), octreotide therapy, and computed tomography (CT)‐guided lymphangiography effectively controlled the chylous leakage without requiring surgery. Conservative measures—low‐fat or medium‐chain triglyceride diets, total parenteral nutrition, and somatostatin analogs—are considered first‐line, while lymphangiography/embolization and eventual surgical ligation may be needed for refractory cases. Conclusions: This case illustrates that CA with a delayed clinical presentation can be successfully treated with a stepwise conservative approach comprising dietary therapy, octreotide, and CT‐guided lymphangiography, even when presenting more than 3 months postoperatively. Moreover, our patient remained free of disease recurrence at 1 year and 8 months postoperatively, underscoring that timely management of CA can avoid delays in adjuvant therapy.