1
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Cornejo KM, Goyal A, Valencia Guerrero A, Astudillo M, Dias-Santagata D, Johnson MM, Feldman AS, Hoang MP. Clinicopathological and Molecular Features of Penile Melanoma With a Proposed Staging System. Am J Surg Pathol 2024; 48:825-833. [PMID: 38808927 DOI: 10.1097/pas.0000000000002247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
Penile melanomas (PM) are an exceedingly rare subtype of mucosal melanoma (MM), and we reviewed the clinicopathologic features and molecular profile in 8 PMs. The patient ages ranged from 46 to 78 (mean: 62.8) years with involvement on the glans (n=5; 62.5%), penile urethra (n=2; 25%), and foreskin (n=1, 12.5%). Tumor depth ranged from 1.6 to 10.0 (mean: 5.25) mm. Most of the patients underwent partial penectomy (n=6; 75%) and sentinel lymph node (LN) biopsy N=7; 87.5%). Seven patients had metastatic disease at diagnosis, 6 involving LNs and 1 the adrenal gland, and 4 died of disease with a mean follow-up period of 40.5 (2 to 95) months. Five of 7 (71%) cases identified 15 molecular alterations within KIT , CDKN2A , NF1 , PTEN , and APC (n=2 each), and NRAS , MAP3K1 , CDH1 , MSH6 , and TERT (n=1 each). Two cases were not found to harbor genetic aberrations, and 1 case failed testing. In addition, we reviewed the English literature and included 93 cases with a reported depth of invasion and follow-up. A total of 101 PMs were analyzed for prognostic parameters, and the overall survival was significantly worse in patients with LN metastasis (P=0.0008), distant metastasis (P=0.0016), and greater depth of invasion (P=0.0222) based upon T-stage. While T4 conferred substantially worse survival, the delineation of the survival curves between T2 and T3 was less clear, and combining T2+T3 disease had a strong prognostic impact ( P =0.0024). Prognostic parameters used in the staging of cutaneous melanomas may also be used in PMs. An alternative staging system expanding the inclusion criteria for T2 might provide a more accurate prognostic stratification.
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Affiliation(s)
- Kristine M Cornejo
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Amrita Goyal
- Department of Dermatology, University of Minnesota, Minneapolis, MN
| | | | | | - Dora Dias-Santagata
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | | | - Adam S Feldman
- Department of Urology, Massachusetts General Hospital, Boston, MA
| | - Mai P Hoang
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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2
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Kaakoua M, Azami MA, Karmouche Y, Haouane MA, El Fadli M, Belbaraka R, Ghoundale O, Essâdi I. Unusual penile localization of melanoma. Clin Case Rep 2022; 10:e6500. [DOI: 10.1002/ccr3.6500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 08/19/2022] [Accepted: 10/08/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
- Mohamed Kaakoua
- Medical Oncology Department Ibn Sina Military Hospital Marrakesh Morocco
| | | | | | | | - Mohammed El Fadli
- Medical Oncology Department Mohammed VI University Hospital Marrakesh Morocco
| | - Rhizlane Belbaraka
- Medical Oncology Department Mohammed VI University Hospital Marrakesh Morocco
| | - Omar Ghoundale
- Urology Department Ibn Sina Military Hospital Marrakesh Morocco
| | - Ismail Essâdi
- Medical Oncology Department Ibn Sina Military Hospital Marrakesh Morocco
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3
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Boui M, Hammoune N, Slioui B, Zouaki Z, Atmane M, Mouhsine A, Haouane MA, Azami MA, Kaakoua M, Assadi I, Boui M, Bouhamidi A. Hepatic Metastasis Revealing a Melanoma of the Penis: Case Report. JMIR DERMATOLOGY 2022; 5:e37400. [PMID: 37632880 PMCID: PMC10334924 DOI: 10.2196/37400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
Melanoma of the penis is a rare tumor with a poor prognosis. We report the case of a 73-year-old patient with no significant medical history, admitted for deterioration of the general condition and bilateral inguinal lymph nodes. An abdominal ultrasound and thoraco-abdomino-pelvic CT (computed tomography) scan revealed metastatic liver nodules, the tumoral nature of which was confirmed by an anatomopathological examination. Further clinical examination revealed papular and ulcerated lesions of the penis located at the urethral meatus and glans penis. These lesions were biopsied and histologically assessed as melanoma. The contribution of imaging in penile tumors is generally not useful for diagnosis as clinical examination is key. However, it has its place in the assessment of locoregional and distant extension. In our case, it was the distant lesions that helped orient the diagnosis. The patient underwent immunotherapical treatment and is still alive 19 months after the diagnosis.
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Affiliation(s)
- Meriem Boui
- Department of Radiology, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco
| | - Nabil Hammoune
- Department of Radiology, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco
| | - Badr Slioui
- Department of Radiology, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco
| | - Zakaria Zouaki
- Department of Radiology, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco
| | - Mehdi Atmane
- Department of Radiology, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco
| | - Abdelilah Mouhsine
- Department of Radiology, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco
| | - Mohamed Amine Haouane
- Department of Anatomopathology, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco
| | - Mohamed Amine Azami
- Department of Anatomopathology, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco
| | - Mohamed Kaakoua
- Department of Oncology, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco
| | - Ismail Assadi
- Department of Oncology, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco
| | - Mohammed Boui
- Department of Dermatology, Military Hospital Mohammed V, Medical University of Rabat, Rabat, Morocco
| | - Ahmed Bouhamidi
- Department of Dermatology, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco
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4
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DePalo DK, Elleson KM, Carr MJ, Spiess PE, Zager JS. Genitourinary melanoma: An overview for the clinician. Asian J Urol 2022; 9:407-422. [DOI: 10.1016/j.ajur.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 12/10/2021] [Accepted: 01/21/2022] [Indexed: 11/24/2022] Open
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5
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Anorectal and Genital Mucosal Melanoma: Diagnostic Challenges, Current Knowledge and Therapeutic Opportunities of Rare Melanomas. Biomedicines 2022; 10:biomedicines10010150. [PMID: 35052829 PMCID: PMC8773579 DOI: 10.3390/biomedicines10010150] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/07/2022] [Accepted: 01/08/2022] [Indexed: 02/05/2023] Open
Abstract
Mucosal melanomas (MM) are rare tumors, being less than 2% of all diagnosed melanomas, comprising a variegated group of malignancies arising from melanocytes in virtually all mucosal epithelia, even if more frequently found in oral and sino-nasal cavities, ano-rectum and female genitalia (vulva and vagina). To date, there is no consensus about the optimal management strategy of MM. Furthermore, the clinical rationale of molecular tumor characterization regarding BRAF, KIT or NRAS, as well as the therapeutic value of immunotherapy, chemotherapy and targeted therapy, has not yet been deeply explored and clearly established in MM. In this overview, focused on anorectal and genital MM as models of rare melanomas deserving of a multidisciplinary approach, we highlight the need of referring these patients to centers with experts in melanoma, anorectal and uro-genital cancers treatments. Taking into account the rarity, the poor outcomes and the lack of effective treatment options for MM, tailored research needs to be promptly promoted.
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6
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Melki G, Mohamed H, Kapoor A, Ha J, Mohamed A, Patel V, Baddoura WJ. A Case of Treated Penile Melanoma with Gastric Recurrence. Middle East J Dig Dis 2021; 13:259-263. [PMID: 36606222 PMCID: PMC9489467 DOI: 10.34172/mejdd.2021.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/11/2021] [Indexed: 01/07/2023] Open
Abstract
Melanoma is a very aggressive skin cancer that could metastasize to any organ in the body. The treatment of melanomas includes surgical resection, chemotherapy, and immunotherapy. After resections, melanomas could recur at the previous site or present as a distant metastatic lesion. The symptoms of melanoma are vague and primarily occur because of the local disruption of the tissue architecture. Presented here is a case of gastric melanoma that presented with abdominal discomfort and melena in a patient with a history of penile melanoma that was completely resected 3 years earlier. This case illustrates the importance of having metastatic lesions to the intestinal tract as a differential for a patient with gastrointestinal hemorrhage.
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Affiliation(s)
- Gabriel Melki
- Department of Internal Medicine, St. Joseph’s University Medical Center, Paterson, NJ, USA
,Corresponding Author: Gabriel Melki, MD 703 Main Street, Paterson, New Jersey 07503, United States of America Tel: + 973 754 2439 Fax: + 973 2243-2570
| | - Hadir Mohamed
- Department of Internal Medicine, St. Joseph’s University Medical Center, Paterson, NJ, USA
| | - Ashima Kapoor
- Department of Internal Medicine, St. Joseph’s University Medical Center, Paterson, NJ, USA
| | - Jewook Ha
- Department of Internal Medicine, St. Joseph’s University Medical Center, Paterson, NJ, USA
| | - Abdalla Mohamed
- Department of Gastroenterology, St. Joseph’s University Medical Center, Paterson, NJ, USA
| | - Varun Patel
- Department of Gastroenterology, St. Joseph’s University Medical Center, Paterson, NJ, USA
| | - Walid J. Baddoura
- Department of Gastroenterology, St. Joseph’s University Medical Center, Paterson, NJ, USA
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7
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Krughoff K, Kilchevksy A, Stadelmann W, Gorman T, Madden-Fuentes R. Penile Melanoma In Situ: Long Term Follow Up. Urology 2020; 141:e51-e52. [PMID: 32289363 DOI: 10.1016/j.urology.2020.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/04/2020] [Accepted: 03/22/2020] [Indexed: 10/24/2022]
Abstract
Penile melanoma in situ is extremely rare. Various treatments have been reported with good success, however follow up is generally limited to 1 year or less. The optimal treatment regimen, pattern of disease progression and utility of sentinel lymph node biopsy are not established. We provide the longest reported follow up for penile malignant melanoma in-situ, highlighting a long-term pattern of recurrence and a route of progression which does not follow more reliable patterns of lymphatic spread known to penile squamous cell carcinoma. A cautious approach should be taken for organ-sparing approaches along with proper patient counseling and close, long-term follow-up.
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8
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Aoki Y, Soma T, Nakamura Y, Fukui N, Sakai Y, Kageyama Y. Malignant melanoma of the male urethra with increased 5- S-cysteinyldopa: A case report. IJU Case Rep 2019; 2:215-217. [PMID: 32743417 PMCID: PMC7292080 DOI: 10.1002/iju5.12086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 05/08/2019] [Indexed: 11/07/2022] Open
Abstract
Introduction We herein present a case of malignant melanoma of the male urethra with an increased serum 5‐S‐cysteinyldopa concentration. Case presentation A 77‐year‐old man visited our hospital complaining dysuria and a dark brown mass protruding from the external urethral meatus. His serum 5‐S‐cysteinyldopa concentration was elevated beyond the upper limit of the reference range. Biopsy of the tumor was performed, and the histological diagnosis was malignant melanoma. He underwent total penectomy, and the serum 5‐S‐cysteinyldopa concentration was normalized. He remained alive without evidence of locoregional recurrence or distant metastases for 6 months after surgery. Conclusion Malignant melanoma of the male urethra is uncommon. The prognosis is favorable if it is detected in its early stages. This case report suggests that measurement of the serum concentration of 5‐S‐cysteinyldopa, a melanin metabolite, is useful for early diagnosis of male urethral melanoma.
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Affiliation(s)
- Yusuke Aoki
- Department of Urology Saitama Cancer Center Ina-machi Saitama Japan.,Department of Urology Juntendo University Graduate School of Medicine Tokyo Japan
| | - Takahiko Soma
- Department of Urology Saitama Cancer Center Ina-machi Saitama Japan
| | - Yuki Nakamura
- Department of Urology Saitama Cancer Center Ina-machi Saitama Japan
| | - Naotaka Fukui
- Department of Urology Saitama Cancer Center Ina-machi Saitama Japan
| | - Yasuyuki Sakai
- Department of Urology Saitama Cancer Center Ina-machi Saitama Japan
| | - Yukio Kageyama
- Department of Urology Saitama Cancer Center Ina-machi Saitama Japan
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9
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Sali GM, Nair KR, Bindhu MR, Ginil Kumar P, Sanjeevan KV, Thomas A. Primary Malignant Melanoma of Urethra-Our Experience with 2 cases. Indian J Surg Oncol 2019; 10:137-140. [PMID: 30948889 DOI: 10.1007/s13193-018-0862-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 12/11/2018] [Indexed: 11/28/2022] Open
Affiliation(s)
- Gaurav Mohan Sali
- 1Department of Urology, Amrita Institute of Medical Sciences and Research Centre, Ponekkara, Kochi, Kerala 682 041 India
| | - Kannan R Nair
- 1Department of Urology, Amrita Institute of Medical Sciences and Research Centre, Ponekkara, Kochi, Kerala 682 041 India
| | - M R Bindhu
- 2Department of Pathology, Amrita Institute of Medical Sciences and Research Centre, Ponekkara, Kochi, Kerala 682 041 India
| | - Pooleri Ginil Kumar
- 1Department of Urology, Amrita Institute of Medical Sciences and Research Centre, Ponekkara, Kochi, Kerala 682 041 India
| | - Kalavampara V Sanjeevan
- 1Department of Urology, Amrita Institute of Medical Sciences and Research Centre, Ponekkara, Kochi, Kerala 682 041 India
| | - Appu Thomas
- 1Department of Urology, Amrita Institute of Medical Sciences and Research Centre, Ponekkara, Kochi, Kerala 682 041 India
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10
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Maruyama Y, Sadahira T, Mitsui Y, Wada K, Tanimoto R, Kobayashi Y, Araki M, Watanabe M, Watanabe T, Nasu Y. Red nodular melanoma of the penile foreskin: A case report and literature review. Mol Clin Oncol 2018; 9:449-452. [PMID: 30233796 DOI: 10.3892/mco.2018.1697] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 08/02/2018] [Indexed: 11/05/2022] Open
Abstract
The penis is an extremely rare primary site for malignant melanomas, and the clinical presentation may vary greatly. We herein present the case of a 71-year-old male patient who presented with a 6-year history of two slow growing, asymptomatic red macules on the penile foreskin. On physical examination, the mobility of the foreskin was good, and there was no metastasis on computed tomography and magnetic resonance imaging. The patient underwent segmental circumcision for treatment and histological diagnosis, and the histological examination revealed a malignant melanoma. As cancer cells were identified at the edge of the tissue specimen and computed tomography-positron emission tomography revealed increased uptake of 18F-fluorodeoxyglucose in the penis, wider resection and a right sentinel lymph node biopsy were performed; both specimens came back negative. Two years after the surgery, there has been no evidence of locoregional recurrence or distant metastases. The aim of this report is to alert physicians to include melanoma in the differential diagnosis of red-pigmented lesions of the penile foreskin.
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Affiliation(s)
- Yuki Maruyama
- Department of Urology, Okayama University Graduate School of Medicine, Okayama, Okayama 700-8558, Japan
| | - Takuya Sadahira
- Department of Urology, Okayama University Graduate School of Medicine, Okayama, Okayama 700-8558, Japan
| | - Yosuke Mitsui
- Department of Urology, Okayama University Graduate School of Medicine, Okayama, Okayama 700-8558, Japan
| | - Koichiro Wada
- Department of Urology, Okayama University Graduate School of Medicine, Okayama, Okayama 700-8558, Japan
| | - Ryuta Tanimoto
- Department of Urology, Okayama University Graduate School of Medicine, Okayama, Okayama 700-8558, Japan
| | - Yasuyuki Kobayashi
- Department of Urology, Okayama University Graduate School of Medicine, Okayama, Okayama 700-8558, Japan
| | - Motoo Araki
- Department of Urology, Okayama University Graduate School of Medicine, Okayama, Okayama 700-8558, Japan
| | - Masami Watanabe
- Department of Urology, Okayama University Graduate School of Medicine, Okayama, Okayama 700-8558, Japan
| | - Toyohiko Watanabe
- Department of Urology, Okayama University Graduate School of Medicine, Okayama, Okayama 700-8558, Japan
| | - Yasutomo Nasu
- Department of Urology, Okayama University Graduate School of Medicine, Okayama, Okayama 700-8558, Japan
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11
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Kouyaté M, D'horpock AF, Aman NA, Traore ZC, Coulibaly ZI, Koui BS, Koffi KD, Koffi KE. Melanoma of the penis: A case diagnosed at the Anatomic Pathology Laboratory of the Treichville Teaching Hospital. HUMAN PATHOLOGY: CASE REPORTS 2018. [DOI: 10.1016/j.ehpc.2017.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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12
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Baraziol R, Schiavon M, Fraccalanza E, De Giorgi G. Melanoma in situ of penis: a very rare entity: A case report and review of the literature. Medicine (Baltimore) 2017; 96:e7652. [PMID: 28885326 PMCID: PMC6393035 DOI: 10.1097/md.0000000000007652] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
RATIONALE Melanoma in situ of the penis is very rare and there are no clear guidelines for its surgical treatment. PATIENT CONCERNS The authors describe the case of a 69-year-old man who presented with an asymptomatic brown macula on his glans penis and foreskin that appeared about 8 years earlier, enlarged in the last few months. DIAGNOSES A diagnostic biopsy showed the characteristics of a melanoma in situ. INTERVENTIONS The authors decided to excise the lesion keeping a healthy margin of 1 cm all over around except close to the urethral meatus, where it was impossible, and where only 5 mm of free margin was excised. A full thickness mucosal graft from oral cavity was performed to repair the defect. OUTCOMES No recurrence or metastasis occurred during 50 months after the operation. LESSONS Considering that at the sixth clinical follow-up the patient was alive and disease free at 50 months after surgery, the chosen treatment has proved successful.
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Affiliation(s)
- Roberto Baraziol
- Azienda Sanitaria Universitaria Integrata di Udine, Plastic Surgery Unit
| | - Mauro Schiavon
- Azienda Sanitaria Universitaria Integrata di Udine, Plastic Surgery Unit
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13
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Jabiles AG, Del Mar EY, Perez GAD, Vera FQ, Montoya LM, Deza CMM. Penile melanoma: a 20-Year analysis of six patients at the National Cancer Institute of Peru, Lima. Ecancermedicalscience 2017; 11:731. [PMID: 28487750 PMCID: PMC5406220 DOI: 10.3332/ecancer.2017.731] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Indexed: 12/24/2022] Open
Abstract
Melanoma of the urogenital tract is extremely rare, accounting for less than 0.1% of melanoma cases. The global literature currently describes only 220 cases of penile melanoma, most commonly located on the glans penis. RESULTS Penile melanoma accounts for 0.7% of penile cancers and 0.18% of melanoma cases. The average patient age for the six cases we reviewed was 44.5 years. Three of these cases (50%) involved ulceration, one case (16.7%) involved lymphovascular invasion, and three cases (50%) involved mitosis ≥ 1 mm2 (0.38-4.7 mm). The average depth of invasion (Breslow) in the five cases that reported this measure was 2.1 mm (0.38-4.7 mm). Applying the American Joint Committee on Cancer tumour, node, metastases (AJCC TNM) staging system, one case was Tx (16.7%), two cases were T1 (33.3%), one case was T2 (16.7%), one case was T3 (16.7%), and one case was T4 (16.7%). Five cases (83.3%) involved wide local resection, and only one case involved partial penile amputation. Four cases (66.7%) involved primary bilateral inguinocrural lymphadenectomy, and only one of those four cases involved lymphatic metastatic disease. One case (16.7%) involved lymphatic recurrence at 12 months in a patient who survived 38 months. One case (16.7%) involved local recurrence at 13 months in a patient who has survived 53 months. Eighty per cent of these patients remain alive, with no evidence of disease after an average follow-up of 96.7 months. CONCLUSION Penile melanoma prognosis depends on the initial clinical stage of the disease. The risk of lymphatic involvement seems to be related to the same risk factors used to assess cutaneous melanoma. Clinicians can thus assess penile melanoma using the AJCC staging system. The use of sentinel lymph node biopsy to determine staging is also becoming more common and could replace prophylactic bilateral inguinal dissection.
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Affiliation(s)
| | | | | | | | - Luis Meza Montoya
- Urological Oncology Department, National Cancer Institute, Lima 34, Peru
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14
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Hambly R, Leonard N, Watkin N, Feighery C. A subtle streak. Clin Exp Dermatol 2016; 41:940-942. [PMID: 27766681 DOI: 10.1111/ced.12931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2016] [Indexed: 11/30/2022]
Affiliation(s)
- R Hambly
- Dermatology Department, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland
| | - N Leonard
- Pathology Department, St James's Hospital, Dublin, Ireland
| | - N Watkin
- Urology Department, St George's Hospital, London, UK
| | - C Feighery
- Dermatology Department, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland
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15
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Takamatsu D, Shiota M, Sugimoto M, Uozumi T, Uchi H, Takeuchi A, Takahashi R, Tatsugami K, Yokomizo A, Oda Y, Furue M, Eto M. A case report of primary malignant melanoma of male urethra with distinct appearance in multiple regions. Int Cancer Conf J 2016; 5:174-177. [PMID: 31149449 PMCID: PMC6498338 DOI: 10.1007/s13691-016-0252-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 04/28/2016] [Indexed: 10/21/2022] Open
Abstract
A 66-year-old man presented with macrohematuria. Cystoscope examination found a 5 mm nodular tumor at external urethral orifice and multiple papillary tumors at fossa navicularis of urethra; those are non-black colored. Transurethral resection of the urethra tumor was performed, and pathologically diagnosed as malignant melanoma. Image examinations showed no lymphadenopathy and metastasis. Accordingly, total penectomy was conducted to remove the remaining tumors, resulting in surgically curative resection. After the operation, monthly interferon-β injection into inguinal region has been administered as adjuvant therapy, resulting in no recurrence at 6 months after penectomy.
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Affiliation(s)
- Dai Takamatsu
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 Japan
| | - Masaki Shiota
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 Japan
| | - Masaaki Sugimoto
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 Japan
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoharu Uozumi
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 Japan
| | - Hiroshi Uchi
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ario Takeuchi
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 Japan
| | - Ryosuke Takahashi
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 Japan
| | - Katsunori Tatsugami
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 Japan
| | - Akira Yokomizo
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masutaka Furue
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masatoshi Eto
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 Japan
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16
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Kollipara R, Vin H, Downing CP, Neely HK, Haws AL, Curtis SW, Tyring SK. Genital melanoma: two cases and an overview of epidemiology and treatment. J Eur Acad Dermatol Venereol 2015; 30:706-7. [PMID: 25650502 DOI: 10.1111/jdv.13002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- R Kollipara
- Center for Clinical Studies, Houston, TX, USA
| | - H Vin
- Baylor College of Medicine, Houston, TX, USA
| | - C P Downing
- Center for Clinical Studies, Houston, TX, USA
| | - H K Neely
- The University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - A L Haws
- Department of Dermatology, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Department of Pathology, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - S W Curtis
- Center for Clinical Studies, Houston, TX, USA
| | - S K Tyring
- Center for Clinical Studies, Houston, TX, USA.,Department of Dermatology, The University of Texas Health Science Center at Houston, Houston, TX, USA
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17
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Li Y, Yuan H, Wang A, Zhang Z, Wu J, Wei Q. Malignant melanoma of the penis and urethra: one case report. World J Surg Oncol 2014; 12:340. [PMID: 25385349 PMCID: PMC4233061 DOI: 10.1186/1477-7819-12-340] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 10/20/2014] [Indexed: 02/05/2023] Open
Abstract
We present a case of a patient with malignant melanoma of the glans penis and urethra, which was found in a 53-year-old man with nonhealing ulcerative penile lesion and bilateral, clinically palpable inguinal lymphadenopathies at diagnosis. A diagnostic biopsy showed the characteristics of a melanoma. We treated the patient with total penectomy and bilateral inguinal lymph node dissection. After surgery, chemotherapy with bleomycin, vincristine and cisplatin and immunotherapy with thymosin injection were started. No recurrence or metastasis occurred during the 3 years after the operation. Melanoma of the penis is very rare, and early diagnosis is important because the patient prognosis is very poor.
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Affiliation(s)
| | | | | | | | | | - Qiang Wei
- Department of Urology, West China Hospital, Sichuan University, Guoxue Xiang #37, Chengdu, Sichuan, P,R, China.
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18
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Update on primary mucosal melanoma. J Am Acad Dermatol 2014; 71:366-75. [PMID: 24815565 DOI: 10.1016/j.jaad.2014.03.031] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 03/10/2014] [Accepted: 03/15/2014] [Indexed: 12/11/2022]
Abstract
Mucosal melanomas are aggressive cancers of mucosal surfaces with clinical and pathologic characteristics distinct from cutaneous melanomas, warranting different staging systems and treatment approaches. Surgical resection is performed frequently for the primary tumor, although the utility of lymph node surgery and radiation therapy is not established. Therapies targeted against C-KIT activating mutations, identified in many mucosal melanomas, are emerging as promising treatments.
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19
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Moses KA, Sfakianos JP, Winer A, Bernstein M, Russo P, Dalbagni G. Non-squamous cell carcinoma of the penis: single-center, 15-year experience. World J Urol 2013; 32:1347-53. [PMID: 24292119 DOI: 10.1007/s00345-013-1216-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 11/19/2013] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Penile cancer is a rare malignancy with less than 5 % being non-squamous cell carcinoma (SCC) primary malignancies. We report our 15-year experience of treating non-SCC penile cancer at a tertiary care cancer center. METHODS We identified 12 patients with non-SCC of the penis from 1996 to 2012. Demographic and clinical data were abstracted, including histological type, surgical treatment, adjuvant therapy, and clinical course. RESULTS Five patients had sarcoma (three leiomyosarcoma, one spindle cell carcinoma, and one epithelioid sarcoma), four had melanoma, two had extramammary Paget's disease (EPD), and one had sebaceous carcinoma. Median follow-up was 37.5 months (mean 45.8 months). Tumor staging for melanoma was pT1aN3, pTisNx, pTxNxM1b, and pT3bN0. Patients with melanoma were treated with penile sparing surgery; two are alive without disease, one is alive with disease, and one patient with metastasis at presentation died of disease at 16.3 months. The patients with sarcoma and deep-seated or node-positive disease died of disease at a mean of 49.7 months. Two patients with EPD were treated with wide local excision of the lesions and were both pT1Nx. The remaining patient had sebaceous carcinoma treated with excisional biopsy and was free of disease at 32.0 months. CONCLUSIONS Non-SCC of the penis is primarily treated surgically, with the goal of complete excision at the time of treatment. The utilization of lymphadenectomy is less clear in these malignancies, but aggressive approaches should be considered in appropriate patients. Tumor stage and nodal status are important in determining patient outcomes.
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Affiliation(s)
- Kelvin A Moses
- Division of Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA,
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20
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Bechara GR, Schwindt ABDS, Ornellas AA, Silva DEAD, Lott FM, Campos FSD. Penile primary melanoma: analysis of 6 patients treated at Brazilian national cancer institute in the last eight years. Int Braz J Urol 2013; 39:823-31. [DOI: 10.1590/s1677-5538.ibju.2013.06.08] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 08/15/2013] [Indexed: 02/03/2023] Open
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21
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22
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Primary malignant melanoma of the penis: a case report. Med Oncol 2011; 29:1300-3. [DOI: 10.1007/s12032-011-9847-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2011] [Accepted: 01/26/2011] [Indexed: 10/18/2022]
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23
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Palliation of Male Genital Cancers. Clin Oncol (R Coll Radiol) 2010; 22:747-54. [DOI: 10.1016/j.clon.2010.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Revised: 07/19/2010] [Accepted: 07/20/2010] [Indexed: 11/22/2022]
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24
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Tritton SM, Shumack S, Fischer G. Fatal delayed presentation of primary melanoma of the penis. Australas J Dermatol 2008; 49:239-41. [DOI: 10.1111/j.1440-0960.2008.00486.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Maeda Y, Ito F, Nakazawa H, Tomoe H, Aiba M, Tanabe K. Penile malignant melanoma in a hemodialysis patient. Int J Urol 2008; 15:741-3. [PMID: 18786196 DOI: 10.1111/j.1442-2042.2008.02084.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
A patient who was receiving hemodialysis treatment developed melanotic macules on the surface of the penis in 2002 and showed a tumor-like mass in the same region in July 2006. The patient presented with a pedunculated tumor of 3 cm in diameter on the right side of his penis. The tumor was resected for biopsy and was diagnosed as malignant melanoma. The melanoma was in stage IIIB with pT4 N1 M0. The patient received interferon-beta for a total of three courses. A computed tomography scan in the 10th postoperative month did not find any additional metastatic foci or recurrence of the tumor. In the present case, side effects caused by interferon were not observed. Therefore, particularly in dialysis patients, immune therapy might be favored over anticancer drug treatment.
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Affiliation(s)
- Yoshiko Maeda
- Department of Urology, Tokyo Women's Medical University, Aoyama Hospital, Tokyo, Japan.
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26
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Izquierdo M, Pastor M, Carrasco L, Moreno C, Kutzner H, Sangueza O, Requena L. Epithelioid blue naevus of the genital mucosa: report of four cases. Br J Dermatol 2008. [DOI: 10.1111/j.1365-2133.2001.04386.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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27
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Te CC, Vemulapalli S, Confer SD, Culkin DJ. Recurrent malignant melanoma of the penis. Urology 2008; 72:1185.e15-6. [PMID: 18372022 DOI: 10.1016/j.urology.2008.01.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2006] [Revised: 01/03/2008] [Accepted: 01/15/2008] [Indexed: 11/27/2022]
Abstract
We report the case of a 72-year-old man with arcal-lentiginous type melanoma of the penis who had undergone local excision and bilateral inguinal lymphadenectomy but developed recurrence at the subcoronal ridge of the glans penis. To our knowledge, this is the 10th reported case in English published studies. We believe this case demonstrates the importance of close follow-up postoperatively and to beware of the recurrence of penile melanoma in patients without total penectomy.
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Affiliation(s)
- Charles C Te
- Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA
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28
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Hankins CL, Kotwal S, Majumder S, Weston P, Phipps A, Anathhanam AJ. Multifocal Melanoma of the Glans Penis. Plast Reconstr Surg 2006; 118:33e-8e. [PMID: 16874188 DOI: 10.1097/01.prs.0000227611.75887.50] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Christopher L Hankins
- Department of Plastic Surgery, Pinderfields General Hospital, Wakefield, United Kingdom. chrishankins501@hotm
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29
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Nejc D, Piekarski J, Pasz-Walczak G, Wroński K, Pluta P, Jeziorski A. The first description of sentinel node biopsy in a patient with amelanotic melanoma of the glans penis. Melanoma Res 2005; 15:565-9. [PMID: 16314746 DOI: 10.1097/00008390-200512000-00015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We present the first description of sentinel node biopsy in a patient with amelanotic melanoma of the glans penis. The patient underwent partial amputation of the penis due to tumor of the glans. Pathologic examination of the postoperative specimen revealed the presence of a very rare malignancy--amelanotic melanoma. Sentinel node biopsy, with the use of the combined radiotracer/blue dye technique, was performed. Preoperative lymphoscintigraphy was performed the day before surgery. During surgery, blue dye mapping and intraoperative detection of gamma radiation were used. Two sentinel nodes were identified in the left inguinal region and one sentinel node in the right inguinal region. All sentinel nodes were an intense violet color; in each case, the level of radiation in the sentinel node was almost 20 times higher than the level of radiation in the node bed. Routine hematoxylin and eosin staining and immunohistochemistry (HMB-45) revealed the presence of micrometastasis in one of the sentinel nodes harvested from the left inguinal region. Consequently, left inguinal, iliac and obturatory lymphadenectomies were performed. The final pathologic examination revealed the presence of one metastasis (diameter, 2 mm) in one of the resected non-sentinel nodes. No relapse has been observed during 18 months of follow-up.
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30
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Abstract
Pigmented lesions of the genital mucosa are more frequent in women than in men. They represent a spectrum of different benign entities. A biopsy is always recommended when the diagnosis cannot be made with certainty on clinical examination and dermatoscopy. Differential diagnostic considerations include melanocytic nevi, blue nevi and syndromes featuring lentigines. Malignant melanomas of the penis and vulva are uncommon tumors which usually appear in elderly patients. They frequently present as painless palpable nodules at routine examination. The treatment consists of excision with histological control of the margins. An aggressive surgical approach has not been shown to prolong the poor 5-year survival. Cooperation with gynecologists and urologists is essential for the optimal management of such patients.
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Affiliation(s)
- U R Hengge
- Klinik für Dermatologie, Heinrich-Heine-Universität, Düsseldorf.
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31
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Sánchez-Ortiz R, Huang SF, Tamboli P, Prieto VG, Hester G, Pettaway CA. MELANOMA OF THE PENIS, SCROTUM AND MALE URETHRA: A 40-YEAR SINGLE INSTITUTION EXPERIENCE. J Urol 2005; 173:1958-65. [PMID: 15879790 DOI: 10.1097/01.ju.0000159207.91737.53] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Genitourinary melanoma is rare and classically associated with a poor prognosis. We describe our experience with 10 patients with penile or urethral involvement. In addition, we present what is to our knowledge the largest reported series of melanoma of the scrotum (6 cases). MATERIALS AND METHODS We reviewed the records of 16 men who presented consecutively to our institution with genitourinary melanoma between 1962 and 2000. Clinical and pathological characteristics were assessed, including Breslow thickness, primary surgical intervention and clinical course. RESULTS Of 10 patients with penile or urethral melanoma 1997 American Joint Committee on Cancer melanoma pathological stage was T1 (depth less than 0.75 mm) in 4, T2 (0.75 to 1.5 mm) in 3 and T3 (1.51 to 4 mm) in 3. Only 1 of 4 patients with clinically palpable inguinal nodes had inguinal metastases at lymphadenectomy (BILND) and 3 who underwent prophylactic superficial BILND had negative findings. In 7 patients with T1-2N0M0 disease there were no local recurrences after wide local excision (WLE) or partial penectomy at a median followup of 35 months. Six of 7 men were rendered disease-free. One patient died of melanoma that developed at a second primary site. The 3 patients with T3 tumors who underwent partial (2) or radical (1) penectomy with or without BILND died of disease (2) or had progression (1). In all patients with penile melanoma the 5-year actuarial disease specific and recurrence-free survival rates were 80% and 60%, respectively, at a median followup of 39 months (range 20 to 210). Six patients with scrotal melanoma were treated with WLE without local recurrences. Three of the 6 patients had palpable inguinal nodes, of whom 2 died after chemotherapy for unresectable disease and 1 died of other causes 51 months after negative BILND. The 3 men with clinically negative groins who did not undergo prophylactic BILND had distant (1) or regional (2) metastases and died of disease. In patients with scrotal melanoma the 5-year actuarial disease specific and recurrence-free survival rates were 33.3% and 33.3%, respectively, at a median followup of 36 months. CONCLUSIONS Partial penectomy or WLE provided effective local control for low stage penile or urethral melanomas and all scrotal lesions. Patients showing clinically positive, proven metastasis died despite appropriate surgical procedures and multi-agent chemotherapy. Prophylactic modified inguinal lymphadenectomy should be considered in select patients with penile, scrotal and anterior urethral melanoma.
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Affiliation(s)
- Ricardo Sánchez-Ortiz
- Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
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32
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Orlandini V, Kolb F, Spatz A, Court B, Ortoli JC, Sabourin C, Wechsler J, Mansard S, Souteyrand P, Arigon V, Andry-Benzaquen P, Avril MF. [Melanoma of the penis: 6 cases]. Ann Dermatol Venereol 2004; 131:541-4. [PMID: 15318136 DOI: 10.1016/s0151-9638(04)93665-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Melanomas of the penis are rare tumors of poor prognosis. METHODS Six cases of melanoma of the penis, followed between 1975 and 2002, were retrospectively reviewed. We collected the data on epidemiological, clinical and pathologic factors, treatment and follow-up. RESULTS The mean age was 44 years. The time to diagnosis was 2 years. Two patients had general predisposing factors for melanoma, and 3 patients local predisposing factors. Two patients had partial penectomy and 4 patients had conservative excision. One patient had local recurrence, and another had metastatic course resulting in death. Five patients out of 6 were alive and disease free at time of the study, with a 24 month follow-up. DISCUSSION The identified risk factors for the development of penile melanoma are melanosis and pre-existing nevus. Delayed diagnosis explains the usually bad prognosis. Classical surgical treatment used to be radical, but recently, conservative surgery has been proposed. For an early diagnosis, genital melanosis requires surgical excision, when technically feasible, and any atypical lesion of the penis should be submitted to a biopsy.
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Affiliation(s)
- V Orlandini
- Service de Dermatologie, Institut Gustave Roussy, Villejuif
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33
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Affiliation(s)
- V Orlandini
- Service de Dermatologie, Institut Gustave Roussy, 39, rue Camille Desmoulins, 94805 Villejuif Cedex
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34
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Millán Sagaste ML, Asensio Lahoz LA, Monge Mirallas JM, Pérez Martín A, Fernández Lerones MJ, Guezmes Domingo AJ, Acinas García O. [Melanoma of the penis]. Actas Urol Esp 2003; 27:152-4. [PMID: 12731331 DOI: 10.1016/s0210-4806(03)72894-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We present a case of penile malignant melanoma. Its rarity of less than 1% of masculine genital malignant neoplasms, the absence of standardised protocols as for other neoplasms, impel us to its publication.
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Affiliation(s)
- M L Millán Sagaste
- Servicio de Urología, Centro de Salud La Vega-Zapatón, Torrelavega, Cantabria
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35
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Blanco Díez A, Montes Couceiro M, Alvarez Castelo L, Suárez Pascual G, Rodríguez Gómez I, Fernández Rosado E, González Martín M. [Penile adenoma: clinical case]. Actas Urol Esp 2002; 26:143-6. [PMID: 11989430 DOI: 10.1016/s0210-4806(02)72749-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Penile melanoma is a very uncommon neoplasm, being reported less than 60 cases. Event yet it outlines not few doubts about its diagnosis and treatment, and in advanced stages represents a challenge for the future since it prognosis is awful at short time. In the present article, its presented a glans melanoma diagnosed and treated at our Service. We make a brief revision of the literature and some basic issues on the management of this entity when it's localized in penis, since in the cases in which it extends far from this organ is yet oncological field.
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Affiliation(s)
- A Blanco Díez
- Servicio de Urología, Hospital Juan Canalejo, La Coruña
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36
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37
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MALIGNANT MELANOMA OF THE PENIS AND SENTINEL LYMPH NODE BIOPSY. J Urol 2001. [DOI: 10.1097/00005392-200111000-00054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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38
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Izquierdo MJ, Pastor MA, Carrasco L, Moreno C, Kutzner H, Sangueza OP, Requena L. Epithelioid blue naevus of the genital mucosa: report of four cases. Br J Dermatol 2001; 145:496-501. [PMID: 11531845 DOI: 10.1046/j.1365-2133.2001.04386.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Epithelioid blue naevi are an unusual cytological variant of blue naevus that have been recently described mostly in patients with the Carney complex, although they may also occur in isolation. This variant of blue naevus is composed of melanin-laden polygonal epithelioid melanocytes situated within the dermis. The neoplastic cells show no maturation with progressive depth of dermal infiltration and, in contrast with the usual stromal changes in blue naevi, epithelioid blue naevi exhibit no dermal fibrosis. We describe four cases of epithelioid blue naevus located on the genital mucosa in four patients with no evidence of the Carney complex. Three male patients showed an epithelioid blue naevus on the mucosa of the glans penis and a female patient had a lesion of the right labium minoris. Histopathologically, the lesions consisted of entirely intradermal melanocytic naevi composed mostly of heavily pigmented epithelioid melanocytes involving the dermis of the genital mucosa. Immunohistochemically, in all cases, epithelioid melanocytes expressed immunoreactivity for S-100 protein, HMB-45, Melan-A and MiTF antibodies.
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Affiliation(s)
- M J Izquierdo
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Avda. Reyes Católicos 2, 28040-Madrid, Spain
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39
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Abstract
Oral pigmentation may be physiological or pathological in nature. It may represent a localized anomaly of limited significance or the presentation of potentially life-threatening multisystem disease. Evaluation of a patient with oral pigmentation requires a systematic approach with resource to appropriate investigations in certain circumstances. A full history of evolution of the pigmentary changes, as well as inquiring into family history, drug ingestion and systemic symptoms of concurrent disease are clearly important in the assessment. The duration, pattern, hue and distribution of colour changes can provide useful diagnostic clues. Special attention is given to newly appearing lesions, or those that have changed significantly in appearance, and biopsy may be needed to validate the clinical impression. This review should enable the reader to increase their familiarity with the assessment of oral pigmentation, the common causes of oral pigmentary change and the rarer disorders of pigmentation seen in this area. The systemic diseases that may give rise to oral pigmentation are detailed and the early signs of oral melanoma are highlighted, as well as the drugs which may cause pigmentary changes in this area and the different pattern of pigmentation they may induce.
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Affiliation(s)
- P Lenane
- Regional Centre of Dermatology Mater Misericordiae Hospital, Dublin, Ireland
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40
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Bañón Pérez VJ, Nicolás Torralba JA, Valdelvira Nadal P, Server Pastor G, Martínez Barba E, Gómez Gómez G, Prieto González A, López Cubillana P, Pérez Albacete M. [Malignant neoplasms of the penis]. Actas Urol Esp 2000; 24:652-8. [PMID: 11103503 DOI: 10.1016/s0210-4806(00)72519-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To assess the behaviour and management of these uncommon neoplasias. MATERIAL AND METHODS Between March 1975 and July 1999, a total of 95 malignant neoplasias of the penis were diagnosed and treated by our unit. Patients mean age was 62 years (28 to 87 years). A retrospective analysis of any associated lesions, biological behaviour of the various neoplasias, as well as therapies used is carried out. RESULTS The squamous carcinoma of the penis (SCP) is the most frequent pathohistological entity entailing 78 cases (82%), followed by verrucous carcinoma (VC) 13 cases (13.5%), basal cells carcinoma 1 case, and melanoma, lymphoma and penile metastasis 1 case each. There is a significant presence of associated lesions with marked predominance of phimosis. The most frequent reason for the call is an injury of the penis (74 cases; 78%). Treatment was mainly partial penectomy (51 patients; 53.7%), followed by conservative treatment in 28 cases (30%). Inguinal lymphadenectomy was performed in 13 patients (14%), due to either a positive nodular biopsy or a persistent adenopathy following antibiotic therapy. CONCLUSIONS Neoplasias showing superior biological behaviour are basal cell carcinoma of the penis, and verrucous carcinoma. Prognosis in SCP is based on pathological status and node involvement. Patients with pT1 tumours showed no metastatic adenopathies after follow-up regardless of cytological grading, and are therefore candidates to watchful waiting with regular monitoring. Melanoma of the penis is a highly aggressive tumour due to its high metastatic capacity with a poor prognosis.
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Affiliation(s)
- V J Bañón Pérez
- Servicio de Urología, Hospital Universitario Virgen de la Arrixaca, Murcia
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41
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Lenane P, Keane C, Connell B, Loughlin S, Powell F. Genital melanotic macules: Clinical, histologic, immunohistochemical, and ultrastructural features. J Am Acad Dermatol 2000. [DOI: 10.1067/mjd.2000.104893] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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42
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Larsson KB, Shaw HM, Thompson JF, Harman RC, McCarthy WH. Primary mucosal and glans penis melanomas: the Sydney Melanoma Unit experience. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1999; 69:121-6. [PMID: 10030812 DOI: 10.1046/j.1440-1622.1999.01497.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Melanomas that arise on mucosal surfaces and the glans penis are rare. METHODS A retrospective study of the Sydney Melanoma Unit experience with 69 patients treated since 1956 for these types of melanomas was undertaken to determine primary lesion site, sex, age at diagnosis, symptoms, clinical stage at first presentation. histopathology, treatment and outcome. RESULTS Primary lesion sites were: nasal cavity (n = 9), oral cavity (n = 16), vulva/vagina (n = 25), anus/rectum (n = 13) and glans penis (n = 6). At diagnosis, 55 patients had local disease only, eight had regional lymph node metastases and six had widespread disease. Local recurrence as the first sign of relapse developed in 15 of the 55 stage I patients (three-stage system). Prognosis for the entire group was poor, only 10% being disease free 3 years after diagnosis and overall 3- and 5-year actuarial survival being 40% and 23%. respectively. The only statistically significant factor influencing survival was stage of disease at diagnosis (P = 0.002). CONCLUSIONS Possible reasons for poor survival include: (i) non-specific symptoms resulting in late presentation; (ii) locally advanced disease not being recognized by a clinician as a rare form of melanoma, resulting in a delay in treatment; (iii) anatomical constraints precluding surgery with generous margins and consequently resulting in a high incidence of local recurrence. Also, rich vascularity and multiple lymphatic drainage pathways may mean a predisposition to early dissemination. Prompt diagnosis and referral to a specialist unit for treatment and follow up are essential. Adequate surgery remains the cornerstone of treatment for these types of melanoma until more effective systemic therapies become available.
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Affiliation(s)
- K B Larsson
- Sydney Melanoma Unit, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
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43
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de Bree E, Sanidas E, Tzardi M, Gaki B, Tsiftsis D. Malignant melanoma of the penis. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 1997; 23:277-9. [PMID: 9236908 DOI: 10.1016/s0748-7983(97)92724-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A case of malignant melanoma of the penis is herein reported. Malignant melanoma of the penis is rare and accounts for a small percentage of malignant melanomas and of malignant penile lesions. The diagnosis is often delayed by the patient's reluctance to consult a physician and by the intrinsic difficulty in clinical diagnosis of such a rare neoplasm. The surgical treatment is not standardized and is shortly discussed. In general, prognosis is poor and most patients die within a few years due to distant metastasis.
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Affiliation(s)
- E de Bree
- Department of Surgical Oncology, University General Hospital, Herakleion, Greece
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Creagh TA, Murphy DM. Malignant melanoma of the penis. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1993; 63:820-1. [PMID: 8274128 DOI: 10.1111/j.1445-2197.1993.tb00348.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- T A Creagh
- Department of Urology, Beaumont Hospital, Dublin, Ireland
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Sagar SM, Retsas S. Metastasis to the penis from malignant melanoma: case report and review of the literature. Clin Oncol (R Coll Radiol) 1992; 4:130-1. [PMID: 1372819 DOI: 10.1016/s0936-6555(05)80985-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A case of metastatic malignant melanoma to the shaft of the penis is described and the literature reviewed to collate the incidence of primary sites which metastasize to the penis. Less than 260 cases of metastasis to the penis have been reported. Of these, 76% are from genitourinary primary sites and 17% are from gastrointestinal primary sites but only one case of metastatic melanoma to the penis has been previously reported. The described case presented with painful priapism while receiving combination chemotherapy for metastatic disease. A CT scan demonstrated a deposit in the left corpora cavernosa and needle aspiration cytology of a plaque attached to the shaft confirmed malignant melanoma cells. Palliation of the painful priapism was achieved by treatment with radiotherapy using large doses per fraction. Retrograde venous or lymphatic spread may have been the cause of a metastasis at this site. Prognosis is very poor.
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Affiliation(s)
- S M Sagar
- Department of Radiotherapy, Westminster Hospital, London, UK
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Abstract
The personal experience with 5 rare types of malignant melanoma is reviewed to point out some of the practical problems in the diagnosis and management of these tumors. The rare forms discussed are conjunctival, nasal, oral, vulvar, and penile melanomas. All pigmented lesions in the oral cavity, but not the penis or vulva, should be prophylactically excised as lesions in the mouth have a higher malignant potential. Local excision of all 5 forms of primary melanomas, no matter how locally advanced they may be, is the sole treatment. Nevertheless, anatomic constraints often preclude surgery with generous margins and consequently local recurrence, particularly for conjunctival, nasal, and oral primary lesions, is usually the major first failure in treatment. Lymph node dissection is only performed if the regional nodes are palpable at the time of first presentation. Elective lymph node dissections are not performed since the patients are often elderly, the lymphatic drainage is usually ambiguous or multiple, and the disease tends to spread hematogenously rather than lymphatically. Surgery still remains the cornerstone of treatment for these rare forms of melanoma but prognosis is very poor since surgery is often a palliative rather than a curative measure. Improved survival may depend on identifying more effective chemotherapeutic and immunologic agents.
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Affiliation(s)
- G W Milton
- Skin & Cancer Foundation, University of Sydney, Royal Prince Alfred Hospital, New South Wales, Australia
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Bundrick WS, Culkin DJ, Mata JA, Gonzalez E, Zitman R, Venable DD. Penile malignant melanoma in association with squamous cell carcinoma of the penis. J Urol 1991; 146:1364-5. [PMID: 1942294 DOI: 10.1016/s0022-5347(17)38096-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We report a case of malignant melanoma of the penis in association with penile squamous cell cancer. Previous regional lymphadenectomy did not prevent subsequent development of regional recurrence. This clinical presentation and the literature are discussed.
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Affiliation(s)
- W S Bundrick
- Department of Urology, Louisiana State University Medical Center, Shreveport
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Barnhill RL, Albert LS, Shama SK, Goldenhersh MA, Rhodes AR, Sober AJ. Genital lentiginosis: a clinical and histopathologic study. J Am Acad Dermatol 1990; 22:453-60. [PMID: 2312832 DOI: 10.1016/0190-9622(90)70064-o] [Citation(s) in RCA: 88] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We studied the clinical and histopathologic characteristics of melanotic macules of the penis and vulva. The 10 lesions studied were relatively large (up to 2 cm), multifocal, irregular in outline, and had variegated pigmentation. Most were regarded as clinically atypical in appearance. Histologic examination of the lesions showed basal layer hyperpigmentation, slight melanocytic hyperplasia, epithelial hyperplasia, and stromal melanophages. No cytologic atypia of melanocytes was detectable. Information is insufficient at present to predict the natural history of genital lentiginosis or its relation to mucocutaneous melanoma.
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Affiliation(s)
- R L Barnhill
- Dermatopathology Laboratory, Yale University School of Medicine, New Haven, Connecticut
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