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Zhao H, Liu C, Li B, Guo JM. Malignant melanoma of the prostate: Primary or metastasis? A case report. World J Clin Cases 2023; 11:5721-5728. [PMID: 37727725 PMCID: PMC10506006 DOI: 10.12998/wjcc.v11.i24.5721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/24/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Malignant melanoma of the prostate is rare. Twenty-five studies describing 45 cases have been reported. Prostate melanoma is characterized by an insidious onset and poor prognosis. The prognosis and treatment vary according to primary or secondary melanoma. CASE SUMMARY A 75-year-old man attended the hospital due to low back pain of 2 mo duration. He denied a history of trauma or abnormal urinary symptoms. Digital rectal examination showed indentation in the left lobe of the prostate, 1 cm in diameter. His prostate-specific antigen was 5.6 ng/mL and 18F-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) showed focal glucose metabolism in the left lobe. Imaging showed bone metastases to T12 and bilateral ribs. Transperineal prostate biopsy was done and three tissue specimens on the left side showed prostate adenocarcinoma (Gleason score 3 + 3 = 6), but the specimen on the right side showed malignant melanoma. The patient underwent T12 tumor resection and pathology findings indicated metastatic malignant melanoma. The patient underwent gastroscopy and colonoscopy, and gastroscopy revealed multiple mucosal black spots in the gastric body and fundus. The patient was diagnosed with secondary malignant prostate melanoma and primary gastric disease. CONCLUSION Diagnosis of primary prostate melanoma requires caution and 18F-FDG-PET/CT may result in false-negative detection of melanoma.
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Affiliation(s)
- Hong Zhao
- Department of Urology, Shanghai Xu-Hui Central Hospital, Shanghai 200001, China
| | - Chun Liu
- Department of Radiology, Shanghai Xu-Hui Central Hospital, Shanghai 200001, China
| | - Bin Li
- Department of Pathology, Shanghai Xu-Hui Central Hospital, Shanghai 200001, China
| | - Jian-Ming Guo
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200001, China
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Caputo A, Addesso M, Zeppa P, D'Antonio A. Malignant melanoma of the prostate gland: A systematic review. Pathol Res Pract 2021; 226:153594. [PMID: 34481214 DOI: 10.1016/j.prp.2021.153594] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 11/17/2022]
Abstract
AIMS Prostatic melanoma is a rare malignancy about which only scattered case reports and no systematic reviews have been published to date. We sought to better inform clinicians and pathologists caring for these patients by gathering all available evidence on the topic. METHODS We performed a systematic review of English and non-English articles indexed in PubMed, EMBASE, Scopus and Google Scholar about primary and metastatic prostatic melanoma. RESULTS In total, 25 studies describing 45 cases were identified. Most cases were metastases to the prostate, with only 10 primary prostatic cases. The median age of patients was 61 years with a wide range, and 89% were symptomatic at presentation, most commonly with obstructive symptoms (83%). Diagnosis requires histopathological analysis and often immunohistochemistry. Metastatic melanoma in the prostate carries a dismal prognosis with median overall survival of 3 months; on the other hand, among primary prostatic melanomas reported in the literature, 29% survived longer than 5 years. The most reasonable therapeutic approach consists in radical surgery possibly followed by adjuvant therapy.
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Affiliation(s)
- Alessandro Caputo
- University of Salerno, Department of Medicine and Surgery, Salerno, Italy.
| | - Maria Addesso
- Hospital Tortora, Department of Pathology, Pagani, Province of Salerno, Italy
| | - Pio Zeppa
- University of Salerno, Department of Medicine and Surgery, Salerno, Italy
| | - Antonio D'Antonio
- University of Salerno, Department of Medicine and Surgery, Salerno, Italy; University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Department of Pathology, Salerno, Italy
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Vergara IA, Wilmott JS, Long GV, Scolyer RA. Genetic drivers of non-cutaneous melanomas: Challenges and opportunities in a heterogeneous landscape. Exp Dermatol 2021; 31:13-30. [PMID: 33455025 DOI: 10.1111/exd.14287] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/16/2020] [Accepted: 01/13/2021] [Indexed: 12/13/2022]
Abstract
Non-cutaneous melanomas most frequently involve the uveal tract and mucosal membranes, including the conjunctiva. In contrast to cutaneous melanoma, they often present at an advanced clinical stage, are associated with worse clinical outcomes and show poorer responses to immunotherapy. The mutational load within most non-cutaneous melanomas reflects their lower ultraviolet light (UV) exposure. The genetic drivers within non-cutaneous melanomas are heterogeneous. Within ocular melanomas, posterior uveal tract melanomas typically harbour one of two distinct, sets of driver mutations and alterations of clinical and biological significance. In contrast to posterior uveal tract melanomas, anterior uveal tract melanomas of the iris and conjunctival melanomas frequently carry both a higher mutational burden and specific mutations linked with UV exposure. The genetic drivers in iris melanomas more closely resemble those of the posterior uveal tract, whereas conjunctival melanomas harbour similar genetic driver mutations to cutaneous melanomas. Mucosal melanomas occur in sun-shielded sites including sinonasal and oral cavities, nasopharynx, oesophagus, genitalia, anus and rectum, and their mutational landscape is frequently associated with a dominant process of spontaneous deamination and infrequent presence of UV mutation signatures. Genetic drivers of mucosal melanomas are diverse and vary with anatomic location. Further understanding of the causes of already identified recurrent molecular events in non-cutaneous melanomas, identification of additional drivers in specific subtypes, integrative multi-omics analyses and analysis of the tumor immune microenvironment will expand knowledge in this field. Furthermore, such data will likely uncover new therapeutic strategies which will lead to improved clinical outcomes in non-cutaneous melanoma patients.
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Affiliation(s)
- Ismael A Vergara
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - James S Wilmott
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Royal North Shore and Mater Hospitals, Sydney, NSW, Australia
| | - Richard A Scolyer
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and New South Wales Health Pathology, Sydney, NSW, Australia
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Nepal P, Nagar A, Tirumani SH, Ojili V. Imaging of non-epithelial neoplasms of the prostate. Abdom Radiol (NY) 2020; 45:4117-4132. [PMID: 32964275 DOI: 10.1007/s00261-020-02774-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/02/2020] [Accepted: 09/10/2020] [Indexed: 02/05/2023]
Abstract
The purpose of this article is to review the spectrum of rare non-epithelial tumors of the prostate. This focused article will help the readers to understand the imaging findings of such rare entities attributed to their clinicopathological features. Radiologists must be familiar with the spectrum of non-epithelial tumors of the prostate, which helps to suggest alternate diagnosis other than adenocarcinoma, when imaging features are atypical. This is important because these tumors have different management approaches and prognoses when compared to adenocarcinoma of the prostate.
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Affiliation(s)
- Pankaj Nepal
- Department of Radiology, St. Vincent's Medical Center, Bridgeport, CT, USA
| | - Arpit Nagar
- Department of Radiology, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Sree Harsha Tirumani
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Vijayanadh Ojili
- Department of Radiology, University of Texas Health, San Antonio, TX, USA.
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Murakami K, Tobino K, Yamaji Y, Ooi R, Munechika M, Enzan Y, Yoshimatsu Y, Tsuruno K, Ide H, Ebi N. Primary Pleural Melanoma: A Case Report and Literature Review. Intern Med 2019; 58:3273-3276. [PMID: 31327838 PMCID: PMC6911739 DOI: 10.2169/internalmedicine.3111-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Primary pleural melanoma is an extremely rare neoplasm, and to the best of our knowledge, there have been only 8 case reports of this condition in the English literature. We herein report a rare case in which the cytological and immunocytochemical analyses of pleural fluid and ultrasonography (US)-guided biopsy of a pleural lesion were useful for the diagnosis primary pleural melanoma. This case highlights the importance of careful physical examinations, cytomorphologic and immunocytochemical analyses of pleural fluid, as well as the utility of US-guided biopsy of the pleural lesions in the diagnosis of primary pleural melanoma.
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Affiliation(s)
- Kojin Murakami
- Department of Respiratory Medicine, Iizuka Hospital, Japan
| | - Kazunori Tobino
- Department of Respiratory Medicine, Iizuka Hospital, Japan
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
| | - Yoshikazu Yamaji
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Japan
| | - Ryunosuke Ooi
- Department of Respiratory Medicine, Iizuka Hospital, Japan
| | | | - Yuki Enzan
- Department of Respiratory Medicine, Iizuka Hospital, Japan
| | | | - Kosuke Tsuruno
- Department of Respiratory Medicine, Iizuka Hospital, Japan
| | - Hiromi Ide
- Department of Respiratory Medicine, Iizuka Hospital, Japan
| | - Noriyuki Ebi
- Department of Respiratory Medicine, Iizuka Hospital, Japan
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Detection and Treatment of Primary Prostatic Melanoma. Urology 2018; 123:16-19. [PMID: 30195014 DOI: 10.1016/j.urology.2018.08.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 08/22/2018] [Accepted: 08/27/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To describe a case of primary melanoma of the prostate gland, then review the published literature of similar cases. METHODS Presentation of the clinical course of a 42-year-old man diagnosed with primary melanoma of the prostate after presenting with gross hematuria. Review of published literature. RESULTS Primary melanoma of the genitourinary tract is a very rare disease, representing less than 1% of all melanomas in men. Only 6 cases of primary melanomas have been previously reported in the English literature. CONCLUSION The current report emphasizes the importance of a multidisciplinary approach and adherence to treatment principles in cutaneous melanoma. With complete surgical extirpation (including extended pelvic lymphadenectomy as needed), close surveillance using 18F-FDG PET/CT, and aggressive systemic treatment in patients with good performance status, cure can be achieved.
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Agarwal P, Nambiyar K, Manju Kaushal, Bhardwaj M. Primary Malignant Melanoma of Pleura: A Case Report and Literature Review. Diagn Cytopathol 2016; 44:648-52. [PMID: 27164972 DOI: 10.1002/dc.23497] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 04/19/2016] [Accepted: 04/23/2016] [Indexed: 12/19/2022]
Abstract
Malignant melanoma is one of the most aggressive and treatment resistant skin cancers. India enjoys a low incidence of melanoma, and age specific incidence rates for cutaneous malignant melanoma (CMM) are being less than 0.5 per 1,000,000. This could be due to under-reporting of melanoma on account of a low index of suspicion by clinicians and pathologists alike. Most common site for origin of primary melanoma is skin, accounting for about 91.2% of all reported primary malignant melanoma cases. Other primary sites are relatively uncommon. Primary pleural melanoma is a very rare tumor and to the best of our knowledge, only seven cases have been reported so far worldwide. We hereby discuss a new case, only second from India. Our patient also had coexistent congenital hairy nevus, an unusual association also noted in two previously reported cases. Excluding primary cutaneous melanoma with pleural metastasis was a diagnostic challenge in this case but multiple cutaneous biopsies together with clinical and findings helped us arrive at this unusual diagnosis. Unfortunately, the patient succumbed to his illness. Diagn. Cytopathol. 2016;44:648-652. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Poojan Agarwal
- Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
| | | | - Manju Kaushal
- Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
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Tosev G, Kuru TH, Huber J, Freier G, Bergmann F, Hassel JC, Pahernik SA, Hohenfellner M, Hadaschik BA. Primary melanoma of the prostate: case report and review of the literature. BMC Urol 2015; 15:68. [PMID: 26169921 PMCID: PMC4501120 DOI: 10.1186/s12894-015-0052-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Accepted: 06/10/2015] [Indexed: 12/05/2022] Open
Abstract
Background Primary melanoma of the prostate has an extremely rare incidence. Only five cases have been reported in the literature and prognosis is poor. The most likely origin of prostatic melanoma is the transitional epithelium of the prostatic urethra. Surgical care for primary melanoma of mucosal sites is less well established than for primary cutaneous melanoma, but excision of the primary is recommended if the patient has no systemic disease. Case presentation Here, we describe a case of primary malignant melanoma of the prostate. A 37-year-old male patient with history of both chemo- and radiation therapy for Hodgkin’s disease was admitted to the University Hospital Heidelberg on suspicion of pleomorphic sarcoma of the bladder. In-house diagnostic work-up revealed a malignant melanoma of the prostate. We then performed radical prostatectomy with extended lymphadenectomy. Despite presumably curative surgery, the patient suffered from early relapse of disease with pulmonary metastasis. Systemic chemotherapy and subsequent immuno-oncologic treatment was thereafter initiated. Conclusion Since prostatic melanoma is a rare disease and a melanoma metastasis of unknown primary is the differential diagnosis, a multidisciplinary approach including early imaging to rule out possible metastases and to search for another potentially existing primary is advisable. To prevent complications related to local tumor progression and to receive tissue for mutational analysis, we recommend complete surgical resection to reduce the tumor mass. Novel immune and targeted oncologic therapies can lead to an improved survival in some cases and support of clinical trials is needed.
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Affiliation(s)
- Georgi Tosev
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany.
| | - Timur H Kuru
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany.
| | - Johannes Huber
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany.
| | - Gerald Freier
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany.
| | - Frank Bergmann
- Institute of Pathology, University of Heidelberg, Heidelberg, Germany.
| | - Jessica C Hassel
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany.
| | - Sascha A Pahernik
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany.
| | - Markus Hohenfellner
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany.
| | - Boris A Hadaschik
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany.
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Abstract
Prostatic melanosis is a very rare, benign lesion characterized by the presence of melanin in the epithelium of the prostate gland and stromal dendritic cells, requiring no additional treatment. It constitutes the melanocytic lesions of the prostate together with blue nevus and malignant melanoma. We present a case with prostatic melanosis because it is rarely seen and its distinction from malignant melanoma is clinicopathologically very important.
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Affiliation(s)
- Hasan Gucer
- Department of Pathology, Recep Tayyip Erdogan University, School of Medicine, Rize, Turkey
| | - Pelin Bagci
- Department of Pathology, Recep Tayyip Erdogan University, School of Medicine, Rize, Turkey
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