Malignant melanoma of the prostate gland: A systematic review

Exploring the landscape of urinary tract melanomas: A review for pathologists and clinicians

Melanomas originating within the urinary tract represent a rare and clinically challenging subset of malignancies. Despite extensive research on cutaneous melanomas, urinary tract melanomas remain relatively unexplored, presenting diagnostic dilemmas and limited treatment consensus. In this comprehensive review, we synthesize current knowledge on the epidemiology, risk factors, clinical presentation, histopathological characteristics, and treatment strategies specific to this disease. Enhancing clinical awareness, refining diagnostic approaches, and exploring novel therapeutic interventions hold promise for improving outcomes in this challenging malignancy subset.

Advances in radiology and pathology of prostate cancer: a review for the pathologist

Multiparametric magnetic resonance imaging (mpMRI) has improved systematic prostate biopsy procedures in the diagnosis of clinically significant prostate cancer (csPCa) by reducing the number of unnecessary biopsies; numerous level one evidence studies have confirmed the accuracy of MRI-targeted biopsy, but, still today, systematic prostate biopsy is recommended to reduce the 15-20% false negative rate of mpMRI. New advanced imaging has been proposed to detect suspicious lesions and perform targeted biopsies especially when mpMRI cannot be performed. Transrectal ultrasound (TRUS) modalities are emerging as methods with greater sensitivity and specificity for the detection of PCa compared to the traditional TRUS; these techniques include elastography and contrast-enhanced ultrasound, as well as improved B-mode and Doppler techniques. These modalities can be combined to define a novel ultrasound approach: multiparametric ultrasound (mpUS). More recently, micro-ultrasound (MicroUS) and prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) have demonstrated to be sensitive for the detection of primary prostatic lesions resulting highly correlated with the aggressiveness of the primary prostatic tumor. In parallel, artificial intelligence is advancing and is set out to deeply change both radiology and pathology. In this study we address the role, advantages and shortcomings of novel imaging techniques for Pca, and discuss future directions including the applications of artificial intelligence-based techniques to imaging as well as histology. The significance of these findings for the practicing pathologist is discussed.

Malignant melanoma of the prostate: Primary or metastasis? A case report

BACKGROUND

Malignant melanoma of the prostate is rare. Twenty-five studies describing 45 cases have been reported. Prostate melanoma is characterized by an insidious onset and poor prognosis. The prognosis and treatment vary according to primary or secondary melanoma.

CASE SUMMARY

A 75-year-old man attended the hospital due to low back pain of 2 mo duration. He denied a history of trauma or abnormal urinary symptoms. Digital rectal examination showed indentation in the left lobe of the prostate, 1 cm in diameter. His prostate-specific antigen was 5.6 ng/mL and 18F-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) showed focal glucose metabolism in the left lobe. Imaging showed bone metastases to T12 and bilateral ribs. Transperineal prostate biopsy was done and three tissue specimens on the left side showed prostate adenocarcinoma (Gleason score 3 + 3 = 6), but the specimen on the right side showed malignant melanoma. The patient underwent T12 tumor resection and pathology findings indicated metastatic malignant melanoma. The patient underwent gastroscopy and colonoscopy, and gastroscopy revealed multiple mucosal black spots in the gastric body and fundus. The patient was diagnosed with secondary malignant prostate melanoma and primary gastric disease.

CONCLUSION

Diagnosis of primary prostate melanoma requires caution and 18F-FDG-PET/CT may result in false-negative detection of melanoma.

Prostatic stromal sarcoma: Report of a rare case in a young male and review of the literature

INTRODUCTION AND IMPORTANCE

Common prostatic neoplasms are diagnosed frequently, whereas rare entities require particular awareness and special clinical management.

CASE PRESENTATION

A 31-year-old man presented with dysuria, hematuria and urinary retention. Histomorphological analysis of material obtained by transurethral resection of the prostate initially favored a sarcomatoid carcinoma, but immunohistochemistry allowed the correct diagnosis of sarcoma of the specialized stroma of the prostate.

CLINICAL DISCUSSION

The patient refused surgical treatment and, despite chemotherapy, he died 8 months after the diagnosis. Herein, we will highlight the diagnostic and therapeutic challenge of prostatic stromal sarcoma by illustrating this case and reviewing the relevant literature.

CONCLUSION

Although rare and shadowed by more common neoplasms that may mimic it, prostatic stromal sarcoma should be considered in the differential diagnosis of bladder and prostate neoplasms because of its dismal prognosis.

Intra-Abdominal Malignant Melanoma: Challenging Aspects of Epidemiology, Clinical and Paraclinical Diagnosis and Optimal Treatment—A Literature Review

According to European consensus-based interdisciplinary guidelines for melanoma, cutaneous melanoma (CM) is the most deadly form of dermatological malignancy, accounting for 90% of the deaths of skin cancer patients. In addition to cutaneous melanoma, mucosal melanoma occurs in four major anatomical sites, including the upper respiratory tract, the conjunctiva, the anorectal region, and the urogenital area. As this cancer type metastasizes, a classification used in the current medical literature is the distinction between secondary lesions and primary malignant melanoma of the abdominal cavity. Given that malignant melanoma is the most common cancer that spreads to the gastrointestinal tract, different imaging modalities compete to diagnose the phenomenon correctly and to measure its extension. Treatment is primarily surgery-based, supported by immunotherapy, and prolongs survival, even when performed at stage IV illness. In the end, special forms of malignant melanoma are discussed, such as melanoma of the genito-urinary tract and amelanotic/achromic melanoma. The importance of this present literature review relies on yielding and grouping consistent and relevant, updated information on the many aspects and challenges that a clinician might encounter during the diagnosis and treatment of a patient with intra-abdominal melanoma.