The Internet Journal of Urology™ ISSN: 1528-8390

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Malignant Melanoma Of The Female Urethra

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Symptom Remission And Improved WBC And RBC Counts In Men With Chronic Genitourinary Complaints Treated With Repetitive Prostatic Massage, Antimicrobials, And Medical Therapy
Pediatric Posterior Urethral Disruption With Resultant Iatrogenic Dilutional Hyponatremia
Incidental Malignant Melanoma: Clinical And Pathological Characteristics
Spontaneous expulsion of Urethral Foreign Body: A case Report
Primary Malignant Melanoma Of The Nasal Cavity And Paranasal Sinuses: A Rare Cause Of Epistaxis In The Elderly

S. Ali
Department of Urology and Pathology
Manor Hospital

E. Siddiqui
Department of Urology and Pathology
Manor Hospital

H. Ojha
Department of Urology and Pathology
Manor Hospital

S. Koneru
Department of Urology and Pathology
Manor Hospital

L. Hock
Department of Urology and Pathology
Manor Hospital

Citation: S. Ali, E. Siddiqui, H. Ojha, S. Koneru & L. Hock : Malignant Melanoma Of The Female Urethra . The Internet Journal of Urology. 2004 Volume 2 Number 1

Keywords: malignant melanoma | urethra | caruncle

Discussion

Abstract

Primary malignant melanoma of the female urethra is a rare disease of old age. The lesion is similar in appearance to a caruncle. Delay in diagnosis is a major factor influencing the course of the disease; therefore, in suspicious cases an urgent urological opinion should be obtained.

A 91-year-old female was referred by the Gynaecologist for a 5cm polypoidal urethral lump and gross haematuria. She had no other urinary symptoms. Preliminary IVU and urine cytology were normal. Cystoscopy showed normal bladder mucosa. A localised excision biopsy of the lesion was performed.

The histology report confirmed a malignant melanoma of the urethra (Fig 3). No other primary was found. She remained continent following surgery. Owing to frail health she was not considered suitable for radical surgery, radiotherapy or chemotherapy.

Six months after excision she was found to have a black spot on the right labium minora, suggestive of metastasis (Fig 1). However the inguinal lymph nodes were not palpable.

A repeat flexible cystoscopy at twelve months showed a recurrent melanoma at the urethra (Fig 2). Although the bladder mucosa was normal, there was an increase in the size of the labial recurrence.

Figure 1: Recurrent malignant melanoma on the medial aspect of Rt. Labial Minora.

Figure 2: Local recurrence seen at the urethra. Indwelling catheter seen.

Figure 3: High power photomicrograph of the tumour showing pleomorphic epitheliod cells with abundant melanin pigment. (Haematoxylin and Eosin x400)

Discussion

Primary malignant melanoma of the female genitourinary tract is rare and a disease of the old age group with an average age of 64 years(range 32-90). The disease is three times more common in women than men.¹

The tumour is usually pigmented, varying in colour from black to blue or brown. It may easily be confused with a caruncle. The tumour usually arises in the distal portion of the urethra. It may spread via the superficial lymphatics to the vulva and vagina, by the deep lymphatics to the inguinal lymph nodes and haematogenously throughout the body.

Delay in diagnosis is a major factor influencing the course of the disease, thus increasing the likelihood of regional node involvement and distant metastasis. This is often due to the patient's reluctance to seek advice, or difficulty in recognising the disease by the physician.

Despite major surgery, radiotherapy or immunotherapy; malignant melanoma usually has a poor prognosis.² Most patients do not survive more than three years. However, an untreated case of malignant melanoma with liver metastasis surviving a 5-year period has been reported.³ Therefore, in women presenting with urethral lesions a diagnosis of malignant melanoma should be considered and an urgent urological opinion sought.

References

1. Block NL, Hotchkiss RS: Malignant melanoma of female urethra, J Urol 1971; 105(2): 251-255 (s)

2. Nissenkorn I, Marshak G: Malignant melanoma of the female urethra, Urology 1987; Vol 29, no.5: 562-565 (s)

3. Ariel IM: Malignant melanoma of the female genital system, Jour of Surg Oncology, 1981; 16: 371-383 (s)

This article was last modified on Fri, 13 Feb 09 14:30:33 -0600

This page was generated on Tue, 09 Feb 10 09:06:24 -0600, and may be cached.

The Internet Journal of Urology™ ISSN: 1528-8390

Malignant Melanoma Of The Female Urethra

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	The Internet Journal of Urology™ ISSN: 1528-8390 \| Home \| Editors \| Current Issue \| Archives \| Instructions for Authors \| Disclaimer \| Share with others \| Malignant Melanoma Of The Female Urethra Read printer friendly Subscribe in a reader Share with others Related Articles Symptom Remission And Improved WBC And RBC Counts In Men With Chronic Genitourinary Complaints Treated With Repetitive Prostatic Massage, Antimicrobials, And Medical Therapy Pediatric Posterior Urethral Disruption With Resultant Iatrogenic Dilutional Hyponatremia Incidental Malignant Melanoma: Clinical And Pathological Characteristics Spontaneous expulsion of Urethral Foreign Body: A case Report Primary Malignant Melanoma Of The Nasal Cavity And Paranasal Sinuses: A Rare Cause Of Epistaxis In The Elderly S. Ali Department of Urology and Pathology Manor Hospital E. Siddiqui Department of Urology and Pathology Manor Hospital H. Ojha Department of Urology and Pathology Manor Hospital S. Koneru Department of Urology and Pathology Manor Hospital L. Hock Department of Urology and Pathology Manor Hospital Citation: S. Ali, E. Siddiqui, H. Ojha, S. Koneru & L. Hock : Malignant Melanoma Of The Female Urethra . The Internet Journal of Urology. 2004 Volume 2 Number 1 Keywords: malignant melanoma \| urethra \| caruncle Table of Contents Discussion Abstract Primary malignant melanoma of the female urethra is a rare disease of old age. The lesion is similar in appearance to a caruncle. Delay in diagnosis is a major factor influencing the course of the disease; therefore, in suspicious cases an urgent urological opinion should be obtained. A 91-year-old female was referred by the Gynaecologist for a 5cm polypoidal urethral lump and gross haematuria. She had no other urinary symptoms. Preliminary IVU and urine cytology were normal. Cystoscopy showed normal bladder mucosa. A localised excision biopsy of the lesion was performed. The histology report confirmed a malignant melanoma of the urethra (Fig 3). No other primary was found. She remained continent following surgery. Owing to frail health she was not considered suitable for radical surgery, radiotherapy or chemotherapy. Six months after excision she was found to have a black spot on the right labium minora, suggestive of metastasis (Fig 1). However the inguinal lymph nodes were not palpable. A repeat flexible cystoscopy at twelve months showed a recurrent melanoma at the urethra (Fig 2). Although the bladder mucosa was normal, there was an increase in the size of the labial recurrence. Figure 1: Recurrent malignant melanoma on the medial aspect of Rt. Labial Minora. Figure 2: Local recurrence seen at the urethra. Indwelling catheter seen. Figure 3: High power photomicrograph of the tumour showing pleomorphic epitheliod cells with abundant melanin pigment. (Haematoxylin and Eosin x400) Discussion Primary malignant melanoma of the female genitourinary tract is rare and a disease of the old age group with an average age of 64 years(range 32-90). The disease is three times more common in women than men.¹ The tumour is usually pigmented, varying in colour from black to blue or brown. It may easily be confused with a caruncle. The tumour usually arises in the distal portion of the urethra. It may spread via the superficial lymphatics to the vulva and vagina, by the deep lymphatics to the inguinal lymph nodes and haematogenously throughout the body. Delay in diagnosis is a major factor influencing the course of the disease, thus increasing the likelihood of regional node involvement and distant metastasis. This is often due to the patient's reluctance to seek advice, or difficulty in recognising the disease by the physician. Despite major surgery, radiotherapy or immunotherapy; malignant melanoma usually has a poor prognosis.² Most patients do not survive more than three years. However, an untreated case of malignant melanoma with liver metastasis surviving a 5-year period has been reported.³ Therefore, in women presenting with urethral lesions a diagnosis of malignant melanoma should be considered and an urgent urological opinion sought. References 1. Block NL, Hotchkiss RS: Malignant melanoma of female urethra, J Urol 1971; 105(2): 251-255 (s) 2. Nissenkorn I, Marshak G: Malignant melanoma of the female urethra, Urology 1987; Vol 29, no.5: 562-565 (s) 3. Ariel IM: Malignant melanoma of the female genital system, Jour of Surg Oncology, 1981; 16: 371-383 (s) This article was last modified on Fri, 13 Feb 09 14:30:33 -0600 This page was generated on Tue, 09 Feb 10 09:06:24 -0600, and may be cached.
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