Management of metastatic malignant melanoma of the bladder

Urological Melanoma: A Comprehensive Review of a Rare Subclass of Mucosal Melanoma with Emphasis on Differential Diagnosis and Therapeutic Approaches

Melanoma is reported as the 19th most common cancer worldwide, with estimated age-standardized incidence rates of 2.8-3.1 per 100,000. Although the origin is most frequently cutaneous, mucosal melanoma has been described several times in literature, and despite its rarity (only 1% of all melanomas), increasing attention is being paid to this disease form. Within this subgroup, melanomas of the uropoetic apparatus are a rarity among rarities. Indeed, less than 50 cases of primary melanoma originating from the urinary bladder have been described, and even less originating from the kidney, renal pelvis and urethra. In this work, we present a detailed review of the literature related to this subclass of mucosal melanoma, delve into the biological landscape of this neoplasm and discuss current approaches, future perspectives and potential therapeutic approaches.

Symptomatic bladder metastasis of malignant melanoma: a case report

Bladder metastasis of cutaneous malignant melanoma is an extremely rare condition, with less than 10 cases reported in the last 30 years in the English literature. Bladder localization is most often asymptomatic, explaining the frequency of cases discovered during autopsy in multi-metastatic patients. We report a case of symptomatic malignant melanoma metastasis to the bladder in a 31-year-old patient.

Metastasis of Malignant Melanoma to Urinary Bladder: A Case Report and Review of the Literature

Aims. Metastatic malignant melanoma of the urinary bladder is a rare clinical entity, with only twenty-three published cases to date. We present a case of this rare entity, a thorough review of the literature, and differential diagnosis of melanoma in the bladder. Methods and Results. A 55-year-old woman with a history of malignant melanoma of the right thigh, excised eight years ago, presented with back pain, fatigue, and hematuria. She underwent computed tomography (CT) scan and was found to have metastases within the liver, spleen, lungs, and urinary bladder. She underwent cystoscopy and transurethral resection of three polypoid lesions. Histologic and immunohistochemical examination revealed metastatic malignant melanoma involving bladder mucosa. Conclusions. This case illustrates the importance of including malignant melanoma in the differential diagnosis of high grade neoplasms of bladder, especially in cases where the relevant clinical history is not available.

Melanoma of the urinary bladder: a review of the literature

Background. Melanomas of the urinary bladder and urethra are rare. Aims. To review the literature on the disease. Methods. Various Internet databases were used to identify reported cases of the disease. Results. Less than 30 cases of primary melanoma of the urinary bladder and urethra have been reported in the literature and they have been associated with melanosis and commonly with metastases. The lesions may be primary or metastatic with no gender preference. The diagnostic features include pigmented raised lesions which histologically exhibit spindled or epitheliod cells, necrosis, mitotic figures, and atypical melanocytes. Immunohistochemically they stain positively with S100; HMB45; and other melanocyte markers, but negatively with Keratin and Vimentin. The treatment involves excision and possibly IL-2. The prognostic factors include size and depth of invasion as well as metastatic lesions. Conclusions. Less than 30 cases (about 24 cases) of the disease have been reported. There are also reports of metastatic melanomas of the urinary bladder emanating from primary melanomas originating elsewhere. Diagnosis of the primary disease is based upon the histological appearance of the lesion, positive staining with S100 and HMB45, and evidence of absence of melanoma elsewhere. Primary melanoma of the bladder is usually a fatal lesion.

Prostate metastasis of malignant melanoma

Metastatic malignant melanoma of the prostate is extremely rare in clinical practice, and only one case has been reported in the English literature in the past 30 years. We report a case of malignant melanoma that metastasized to the prostate and review the current literature. A 50-year-old man with a history of malignant melanoma metastasis to the left axilla, which was excised 3 years ago, presented with lower urinary tract symptoms and gross hematuria. He underwent cystoscopy and transurethral resection of the prostate. The pathological examination showed metastatic malignant melanoma of the prostate gland. The patient died 6 months after the transurethral resection.

Metastatic malignant melanoma to the bladder: a case series

BACKGROUND

Metastatic melanoma to the bladder is rarely reported, and the role of surgery is still largely unknown. We review 4 such cases and highlight their management and outcomes. We also review the relevant literature.

METHODS

The Mayo Clinic tumor database was searched and 4 such cases were found.

RESULTS

All 4 patients were treated locally with transurethral resection. The only patient who had a solitary metastasis did relatively well, having no evidence of disease 10 months after his presentation, while the other 3 died within 6 months. The literature highlights various approaches to management, but there is no definitive evidence that radical cystectomy offers any benefit over transurethral resection.

CONCLUSION

Resection may improve survival in the setting of a solitary metastasis, but there is no evidence that radical cystectomy offers any benefit over local resection. With diffuse disease, however, resection is likely only beneficial for treatment of hematuria.

[Bladder metastasis of malignant melanoma: a case report and review of literature]

Metastatic malignant melanoma to the urinary bladder remains rare in clinical practice with less than 10 cases reported in the last 30 years in the literature. According to our knowledge, our case report is the first in french language.