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Switlyk MD, Hopland A, Reitan E, Sivanesan S, Brennhovd B, Axcrona U, Hole KH. Multiparametric Magnetic Resonance Imaging of Penile Cancer: A Pictorial Review. Cancers (Basel) 2023; 15:5324. [PMID: 38001583 PMCID: PMC10670261 DOI: 10.3390/cancers15225324] [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: 10/04/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
The role of multiparametric magnetic resonance imaging (mpMRI) in assessing penile cancer is not well defined. However, this modality may be successfully applied for preoperative staging and patient selection; postoperative local and regional surveillance; and assessments of treatment response after oncological therapies. Previous studies have been mostly limited to a few small series evaluating the accuracy of MRI for the preoperative staging of penile cancer. This review discusses the principles of non-erectile mpMRI, including functional techniques and their applications in evaluating the male genital region, along with clinical protocols and technical considerations. The latest clinical classifications and guidelines are reviewed, focusing on imaging recommendations and discussing potential gaps and disadvantages. The development of functional MRI techniques and the extraction of quantitative parameters from these sequences enables the noninvasive assessment of phenotypic and genotypic tumor characteristics. The applications of advanced techniques in penile MRI are yet to be defined. There is a need for prospective trials and feasible multicenter trials due to the rarity of the disease, highlighting the importance of minimum technical requirements for MRI protocols, particularly image resolution, and finally determining the role of mpMRI in the assessment of penile cancer.
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Affiliation(s)
- Marta D. Switlyk
- Department of Radiology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (E.R.); (K.H.H.)
| | - Andreas Hopland
- Department of Urology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (A.H.); (S.S.); (B.B.)
| | - Edmund Reitan
- Department of Radiology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (E.R.); (K.H.H.)
| | - Shivanthe Sivanesan
- Department of Urology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (A.H.); (S.S.); (B.B.)
- Institute of Clinical Medicine (KlinMED), Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
| | - Bjørn Brennhovd
- Department of Urology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (A.H.); (S.S.); (B.B.)
| | - Ulrika Axcrona
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway;
| | - Knut H. Hole
- Department of Radiology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (E.R.); (K.H.H.)
- Institute of Clinical Medicine (KlinMED), Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
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2
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Franceschelli A, Palmisano F, Gentile G, Vagnoni V, Zannetti G, Cipriani R, Colombo F. Melanoma of glans penis and urethra: A case report and systematic review of the literature of a rare and complex neoplasm. Urologia 2023; 90:766-774. [PMID: 34528492 DOI: 10.1177/03915603211046471] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To evaluate the features and prognosis of melanoma of glans penis and urethra, with the presentation of a significant case report. MATERIALS AND METHODS A systematic literature review was performed using the MEDLINE (PubMed) and Cochrane Libraries databases to identify all cases of male mucosal melanoma reported. RESULTS Two hundred fifty-two patients with male mucosal primary melanoma were found. Glans penis and fossa navicularis as primary site includes the 81.6% of all lesions considered. Median Breslow's depth is 2.1 mm, whereas nine in situ melanomas have been reported. At the diagnosis, the disease was at a non-localized stage in 21.4% for glans penis melanomas and 11.7% urethral lesions, respectively. The 2 and 5-year survival for glans melanoma is 62.5% and 38.4%; higher rates were observed in the 2012-2020 period (76% and 58.8%, respectively). Two-year survival for urethral melanomas is 66.7%, while 5-year survival is 12.5%. 22 patients survived over 5 years with a Breslow's depth reported always < 3.3 mm. CONCLUSION Melanoma of the glans penis and urethra is a rare neoplasm associated with a poor prognosis, however recent reports show higher survival rates. Surgery remains the mainstay for a localized disease. Taking into account the small number of cases reported, topical imiquimod seems to be a valid non-surgical alterative for melanoma in situ. The use of immunotherapy and targeted therapy should be considered only in an adjuvant setting according to the recommendations of cutaneous melanoma; however, additional clinical data on male mucosal melanoma are needed to draw definitive conclusions.
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Affiliation(s)
| | - Franco Palmisano
- Department of Urology, ASST Fatebenefretalli-Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Giorgio Gentile
- Andrology Unit, St. Orsola University Hospital, Bologna, Italy
| | - Valerio Vagnoni
- Andrology Unit, St. Orsola University Hospital, Bologna, Italy
| | - Guido Zannetti
- Department of Plastic and Reconstructive Surgery, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Riccardo Cipriani
- Department of Plastic and Reconstructive Surgery, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Fulvio Colombo
- Andrology Unit, St. Orsola University Hospital, Bologna, Italy
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3
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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. [PMID: 36415702 PMCID: PMC9675376 DOI: 10.1002/ccr3.6500] [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: 05/15/2022] [Revised: 08/19/2022] [Accepted: 10/08/2022] [Indexed: 11/21/2022] Open
Abstract
Penile's melanoma is a rare situation, often associated with late diagnosis and high morbidity and mortality. We report the case of a 70-year-old man. He represented progressive skin lesions of the penile gland. A surgical biopsy with histopathological and immunohistochemical studies established the diagnosis of malignant melanoma of the penis in the metastatic stage. This case was managed by palliative immunotherapy and is currently under treatment by Pembrolizumab. Malignant melanoma of the penis represents an exceptional situation, in which only rapid diagnosis at an early stage allows treatment with optimal therapeutic results.
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Affiliation(s)
- Mohamed Kaakoua
- Medical Oncology DepartmentIbn Sina Military HospitalMarrakeshMorocco
| | | | | | | | - Mohammed El Fadli
- Medical Oncology DepartmentMohammed VI University HospitalMarrakeshMorocco
| | - Rhizlane Belbaraka
- Medical Oncology DepartmentMohammed VI University HospitalMarrakeshMorocco
| | - Omar Ghoundale
- Urology DepartmentIbn Sina Military HospitalMarrakeshMorocco
| | - Ismail Essâdi
- Medical Oncology DepartmentIbn Sina Military HospitalMarrakeshMorocco
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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. [PMID: 36381597 PMCID: PMC9643129 DOI: 10.1016/j.ajur.2022.01.003] [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: 10/02/2021] [Revised: 12/10/2021] [Accepted: 01/21/2022] [Indexed: 11/24/2022] Open
Abstract
Genitourinary (GU) melanoma is a rare presentation of melanoma accounting for approximately 0.5% of all melanomas. GU melanomas include primary melanomas of the vulva, vagina, uterine cervix, ovary, penis, scrotum, urethra, bladder, ureter, and kidney. These melanomas are often diagnosed in advanced stages and stigma is thought to contribute to delays in presentation. As the likely diagnosing provider, it is imperative that dermatologists, urologists, and gynecologists are aware of these uncommon sites of presentation. While there have been major advances in the treatment of melanomas as a whole in the last 10 years, their applications to GU melanomas have often been overlooked. GU melanomas have not been included in many of the major phase III clinical trials which brought contemporary advanced treatments to market and the prognoses for GU melanomas remain poor. Due to the rarity of GU melanomas, much of the literature provides generalized recommendations across multiple different organs affected by GU melanomas or omits certain topics, making it difficult to appreciate the fundamentals of the individual presentations. This review aimed to provide background information on the pathogenesis and epidemiology of the different sites of GU melanomas and categorize data specific to the presentation, staging, treatment, and prognosis of each type of GU melanoma to guide the clinician. It was also meant to encourage a multidisciplinary approach to the management of these patients as it spans the expertise of surgical oncologists, medical oncologists, radiation oncologist, dermatologists, urologists, and gynecologists.
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Affiliation(s)
| | - Kelly M. Elleson
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Michael J. Carr
- Department of Surgery, University of Louisville, Louisville, KY, USA
| | - Philippe E. Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Jonathan S. Zager
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA
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5
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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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6
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Cazzato G, Colagrande A, Cimmino A, Caporusso C, Candance PMV, Trabucco SMR, Zingarelli M, Lorusso A, Marrone M, Stellacci A, Arezzo F, Marzullo A, Serio G, Filoni A, Bonamonte D, Romita P, Foti C, Lettini T, Loizzi V, Cormio G, Resta L, Rossi R, Ingravallo G. Urological Melanoma: A Comprehensive Review of a Rare Subclass of Mucosal Melanoma with Emphasis on Differential Diagnosis and Therapeutic Approaches. Cancers (Basel) 2021; 13:cancers13174424. [PMID: 34503234 PMCID: PMC8431506 DOI: 10.3390/cancers13174424] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/24/2021] [Accepted: 08/30/2021] [Indexed: 02/05/2023] Open
Abstract
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.
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Affiliation(s)
- Gerardo Cazzato
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (C.C.); (P.M.V.C.); (S.M.R.T.); (A.M.); (G.S.); (T.L.); (L.R.); (R.R.); (G.I.)
- Correspondence: ; Tel.: +39-3405203641
| | - Anna Colagrande
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (C.C.); (P.M.V.C.); (S.M.R.T.); (A.M.); (G.S.); (T.L.); (L.R.); (R.R.); (G.I.)
| | - Antonietta Cimmino
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (C.C.); (P.M.V.C.); (S.M.R.T.); (A.M.); (G.S.); (T.L.); (L.R.); (R.R.); (G.I.)
| | - Concetta Caporusso
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (C.C.); (P.M.V.C.); (S.M.R.T.); (A.M.); (G.S.); (T.L.); (L.R.); (R.R.); (G.I.)
| | - Pragnell Mary Victoria Candance
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (C.C.); (P.M.V.C.); (S.M.R.T.); (A.M.); (G.S.); (T.L.); (L.R.); (R.R.); (G.I.)
| | - Senia Maria Rosaria Trabucco
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (C.C.); (P.M.V.C.); (S.M.R.T.); (A.M.); (G.S.); (T.L.); (L.R.); (R.R.); (G.I.)
| | - Marcello Zingarelli
- Section of Urology, Deparment of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (M.Z.); (A.L.)
| | - Alfonso Lorusso
- Section of Urology, Deparment of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (M.Z.); (A.L.)
| | - Maricla Marrone
- Section of Legal Medicine, Interdisciplinary Department of Medicine, Bari Policlinico Hospital, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.M.); (A.S.)
| | - Alessandra Stellacci
- Section of Legal Medicine, Interdisciplinary Department of Medicine, Bari Policlinico Hospital, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.M.); (A.S.)
| | - Francesca Arezzo
- Section of Ginecology and Obstetrics, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (F.A.); (V.L.); (G.C.)
| | - Andrea Marzullo
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (C.C.); (P.M.V.C.); (S.M.R.T.); (A.M.); (G.S.); (T.L.); (L.R.); (R.R.); (G.I.)
| | - Gabriella Serio
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (C.C.); (P.M.V.C.); (S.M.R.T.); (A.M.); (G.S.); (T.L.); (L.R.); (R.R.); (G.I.)
| | - Angela Filoni
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.F.); (D.B.); (P.R.); (C.F.)
| | - Domenico Bonamonte
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.F.); (D.B.); (P.R.); (C.F.)
| | - Paolo Romita
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.F.); (D.B.); (P.R.); (C.F.)
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.F.); (D.B.); (P.R.); (C.F.)
| | - Teresa Lettini
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (C.C.); (P.M.V.C.); (S.M.R.T.); (A.M.); (G.S.); (T.L.); (L.R.); (R.R.); (G.I.)
| | - Vera Loizzi
- Section of Ginecology and Obstetrics, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (F.A.); (V.L.); (G.C.)
| | - Gennaro Cormio
- Section of Ginecology and Obstetrics, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (F.A.); (V.L.); (G.C.)
| | - Leonardo Resta
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (C.C.); (P.M.V.C.); (S.M.R.T.); (A.M.); (G.S.); (T.L.); (L.R.); (R.R.); (G.I.)
| | - Roberta Rossi
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (C.C.); (P.M.V.C.); (S.M.R.T.); (A.M.); (G.S.); (T.L.); (L.R.); (R.R.); (G.I.)
| | - Giuseppe Ingravallo
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (C.C.); (P.M.V.C.); (S.M.R.T.); (A.M.); (G.S.); (T.L.); (L.R.); (R.R.); (G.I.)
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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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8
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Samaan S, Quddus MR, Matoso A. "Man in Istanbul" Lesions of the Urinary Tract (Known Entities in an Unusual Context): Melanoma, Carcinoid Tumors, Epithelioid Angiosarcoma. Surg Pathol Clin 2018; 11:825-836. [PMID: 30447844 DOI: 10.1016/j.path.2018.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Certain tumors are more difficult to recognize when they present in an unusual location. Within the urinary tract, primary melanomas, carcinoid tumors, or epithelioid angiosarcoma could present diagnostic challenges due to their infrequent occurrence. This article emphasizes the clinical and histopathologic features of these entities and their differential diagnoses including the immunophenotype and their prognoses.
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Affiliation(s)
- Sameh Samaan
- Department of Pathology, The Johns Hopkins Medical Institutions, Johns Hopkins Hospital, Weinberg 2242, 401 North Broadway, Baltimore, MD 21231-2410, USA
| | - M Ruhul Quddus
- Department of Pathology, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI 02903, USA
| | - Andres Matoso
- Department of Pathology, The Johns Hopkins Medical Institutions, Johns Hopkins Hospital, Weinberg 2242, 401 North Broadway, Baltimore, MD 21231-2410, USA; Department of Urology, The Johns Hopkins Medical Institutions, Johns Hopkins Hospital, Weinberg 2242, 401 North Broadway, Baltimore, MD 21231-2410, USA; Department of Oncology, The Johns Hopkins Medical Institutions, Johns Hopkins Hospital, Weinberg 2242, 401 North Broadway, Baltimore, MD 21231-2410, USA.
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9
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Bittar JM, Bittar PG, Wan MT, Kovell RC, Guzzo TJ, Shin TM, Etzkorn JR, Sobanko JF, Miller CJ. Systematic Review of Surgical Treatment and Outcomes After Local Surgery of Primary Cutaneous Melanomas of the Penis and Scrotum. Dermatol Surg 2018; 44:1159-1169. [PMID: 29985865 DOI: 10.1097/dss.0000000000001579] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Few data exist to guide surgical management and counseling about local recurrence after surgery of primary male genital melanoma. OBJECTIVE To compile all available data on local recurrence rates after surgery of primary cutaneous melanoma of the penis and scrotum. MATERIALS AND METHODS A systematic review of PubMed, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Excerpta Medica database (EMBASE), and Web of Science identified all surgically treated penile and scrotal melanomas that reported local recurrence status and follow-up time. RESULTS One hundred twenty-seven melanomas from 74 manuscripts were included. Eighty-six percent of melanomas were located on the penis, and 14% were located on the scrotum. Average follow-up time was 35.7 months. Scrotal melanomas were predominantly treated with organ-sparing surgeries (16/18, 88.9%), whereas penile melanomas were treated more often with amputation (61/109, 56.0%). Overall, local recurrence rate was 15.7% (20/127). Local recurrence rates for penile cases were 18.8% (9/48) after organ-sparing surgery versus 13.1% (8/61) for amputative surgery. Local recurrence rates were 66.7% (4/6) after positive surgical margins versus 10.2% (5/49) after negative surgical margins. CONCLUSION Local recurrence rates are high after both organ-sparing and amputative surgery of primary cutaneous melanoma of the penis and scrotum. There is a need to standardize reporting for this rare tumor, as more complete data are necessary to develop consensus guidelines for surgical management of male genital melanoma.
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Affiliation(s)
- Julie M Bittar
- Indiana University School of Medicine, Indianapolis, Indiana
| | - Peter G Bittar
- Duke University School of Medicine, Durham, North Carolina
| | - Marilyn T Wan
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robert C Kovell
- Department of Surgery, Division of Urology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Thomas J Guzzo
- Department of Surgery, Division of Urology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Thuzar M Shin
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jeremy R Etzkorn
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph F Sobanko
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Christopher J Miller
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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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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Abstract
PURPOSE OF REVIEW Mucosal melanoma is of great interest due to its aggressive behavior and less favorable prognosis. The literature is mainly case reports and case series. Here, we will collect the knowledge on mucosal melanoma from the last decade and review the literature. The main focus is being site-specific clinical features, treatment, and prognosis. RECENT FINDINGS The use of immunotherapy gain ground as for others subsets of melanoma. Anti-CTLA-4 and anti-PD-1/ PD-L1 blockade in mucosal melanoma have been evaluated in recent studies. Clinical trials are ongoing. The etiology of mucosal melanomas remains unknown. Head and neck mucosal melanomas are most common. Wide excision surgery is the treatment of choice. The effect of adjuvant therapy on survival remains questionable due to the limited knowledge. Radiotherapy seems to give better local control. The overall five-year survival rate for mucosal melanomas is 0-45%. Recent data indicates that this may be improved by the immunotherapy in the years to come.
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Affiliation(s)
- Simon Skovsted Yde
- Plastic Surgical Research Unit, Department of Plastic Surgery, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark.
| | - Pia Sjoegren
- Plastic Surgical Research Unit, Department of Plastic Surgery, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark
| | - Martin Heje
- Plastic Surgical Research Unit, Department of Plastic Surgery, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark
| | - Lars B Stolle
- Plastic Surgical Research Unit, Department of Plastic Surgery, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark
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