Malignant melanoma of the penis

Melanoma in situ of penis: a very rare entity: A case report and review of the literature

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.

Malignant melanoma of the penis and urethra: one case report

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.

Primary genitourinary melanoma

OBJECTIVES

To describe the presentation, management, and clinical outcome of patients with genitourinary melanoma.

METHODS

We identified 14 patients with genitourinary melanoma treated at Memorial Sloan-Kettering Cancer Center, New York and Tripler Army Medical Center, Honolulu, Hawaii. The presentation, surgical treatment, disease progression, and outcome of these patients were reviewed. Survival was analyzed, using the Kaplan-Meier product limit method.

RESULTS

The presentation and management of patients with genitourinary melanoma were varied. Overall, the prognosis was poor, with a median survival of 43 months, and only 3 patients were alive, without disease, at last follow-up. Our findings confirm a poor prognosis in patients with this rare disease.

CONCLUSIONS

Genitourinary melanoma is a rare form of the disease with an unfavorable clinical outcome. Less than one third of patients survive long term, although patients with scrotal melanomas may have a better prognosis.