nach oben

Archives of Gynecology and Obstetrics

Erschienen in:

01.05.2014 | Review

Primary malignant melanoma of the urethra: a systematic analysis of the current literature

verfasst von: Samer El-Safadi, Rebecca Estel, Peter Mayser, Karsten Muenstedt

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 5/2014

Einloggen, um Zugang zu erhalten

Abstract

Background

Primary malignant melanoma of the urethra is a rare tumour that most commonly affects the meatus and distal urethra. General prognosis seems to be poor. To date, there have been no systematic reviews on this topic. Therefore, we aimed to gain more insight into this rare type of tumour.

Methods

Medline and PubMed were searched and all cases of urethral melanoma reported as single case reports or small case series were reviewed as the first step in the combined analyses of all the cases reported.

Results

We reviewed 150 cases. The most frequent presentation was urethral mass. The first line of treatment was surgery such as tumour excision or total urethrectomy. Three times more women were diagnosed than men with a mean age of 64.7 years (SD 10.7; median 65.5; range 28–96 years). Forty-three patients (36 %) underwent adjuvant treatment including chemotherapy, radiotherapy or immunotherapy. Recurrences were observed in 71.4 % (n = 80) of the cases, mainly local recurrences (n = 44; 55 %) and metastases in the inguinal lymph nodes (n = 31; 28 %). Recurrences occurred within 12.5 months on average (SD 12.6; range 1–48). The treatments of recurrences were surgery, chemotherapy, radiotherapy and immunotherapy. These treatment options influenced the course of the disease.

Conclusions

Urethral melanoma is mainly a disease of older people with an average age of 64 years. The study showed that the T-stage as a basis of depth invasion is a prognostic factor for urethral melanoma. Moreover, pulmonary metastases (cM2), local recurrence and systemic recurrence influence prognosis. The T-stage classification is useful because of its prognostic ability.

Van Geel AN, den Bakker MA, Kirkels W, Horenblas S, Kroon BBR, de Wilt JHW, Eggermont AAM, Mooi WJ, van der Aa MNA (2007) Prognosis of primary mucosal penile melanoma: a series of 19 Dutch patients and 47 Patients from the literature. Urology 70:143–147PubMedCrossRef

Reed CAL (1896) Melano-sarcoma of the female urethra: urethrectomy recovery. Am J Obstet Gynecol 34:864–872

Yoshizawa T, Kawata N, Sato K, Hirakata H, Igarashi T, Ichinose T, Yamaguchi K, Takahashi S (2007) Primary malignant melanoma of the female urethra. Urology 70:1222PubMedCrossRef

Gupta R, Bhatti SS, Dinda AK, Singh MK (2007) Primary melanoma of the urethra: a rare neoplasm of the urinary tract. Int Urol Nephrol 39:833–836PubMedCrossRef

Petersen RO (1992) Urologic Pathology. JB Lippincott, Philadelphia

Oliva E, Quinn TR, Amin MB, Eble JN, Epstein JI, Srigley JR, Young RH (2000) Primary malignant melanoma of the urethra: a clinicopathologic analysis of 15 cases. Am J Surg Pathol 24:785–796PubMedCrossRef

Abrams M (1955) Primary melanoma of the female urethra. J Urol 74:371–374PubMed

Akbas A, Akman T, Erdem MR, Antar B, Kilicarslan I, Onol SY (2010) Female urethral malignant melanoma with vesical invasion: a case report. Kaohsiung J Med Sci 26:96–98PubMedCrossRef

Alvarez Kinderlan J, Merchan Garcia JA, Olmo Cerezo I, Moreno Rodriguez MM, Gonzalez Arlanzon MM (2000) Primary malignant melanoma of the female urethra. Report of a case. Actas Urol Esp 24:488–490CrossRef

10.

Ander H, Esen T, Tellaloglu S, Uysal V (1991) Successful management of malignant melanoma of male urethra with local excision and adjuvant radiochemotherapy. Prog Clin Biol Res 370:379–383PubMed

11.

Aragona F, Maio G, Piazza R, Salmaso R (1995) Primary malignant melanoma of the female urethra: a case report. Int Urol Nephrol 27:107–111PubMedCrossRef

12.

Batsakis JG, Suarez P (2000) Mucosal melanomas: a review. Adv Anat Pathol 7:167–180PubMedCrossRef

13.

Barbagli G, Natali A, Urso C, Barbanti G, Menchi I, Moroni F (1988) Primary malignant melanoma of the female urethra: a case report with immunohistochemical findings. Urol Int 43:110–112PubMedCrossRef

14.

Begun FP, Grossman HB, Diokno AC, Sogani PC (1984) Malignant melanoma of the penis and male urethra. J Urol 132:123–125PubMed

15.

Benson RC Jr, Tunca JC, Buchler DA, Uehling DT (1982) Primary carcinoma of the female urethra. Gynecol Oncol 14:313–318PubMedCrossRef

16.

Block NL, Hotchkiss RS (1971) Malignant melanoma of the female urethra: report of a case with 5 year survival and review of the literature. J Urol 105:251–255PubMed

17.

Bobin JY, Gaude JM, Bailly C, Gerard JP, Mayer M (1983) Primary malignant melanomas of the urethra. Apropos of 4 cases. J Urol (Paris) 89:105–109

18.

Bracken RB, Johnson DE, Miller LS, Ayala AG, Gomez JJ, Rutledge F (1976) Primary carcinoma of the female urethra. J Urol 116:188–192PubMed

19.

Buckle AE (1969) Primary malignant melanoma of the female urethra. Br J Surg 56:548–550PubMedCrossRef

20.

Caballero Alcantara J, Carrero Lopez V, Vazquez Blanc S, Calahorra Fernandez L, Minana Lopez B, Fernandez Aparicio T, Leiva Galvis O (1993) Tumors of the female urethra: presentation of cases and review of the literature (Article in Spanish). Actas Urol Esp 17:8–21PubMed

21.

Cabezón Gutiérrez L, Márquez-Rodas I, Soria Lovelle A, Martín Marino A, Alvarez Alvarez R, Muñoz Martín AJ (2010) Melanoma of male urethra: a clinical case (Article in Spanish). Actas Urol Esp 34:651–652PubMedCrossRef

22.

Comploj E, Palermo S, Trenti E, Lodde M, Mian C, Carella R, Pycha A (2009) Unexpected long survival in primary malignant melanoma of the male urethra. Case Rep Dermatol 1:93–99PubMedCentralPubMedCrossRef

23.

Das P, Kumar N, Ahuja A, Jain A, Ray R, Sarkar C, Gupta SD (2010) Primary malignant melanoma at unusual sites: an institutional experience with review of literature. Melanoma Res 20:233–239PubMed

24.

Davis JW, Schellhammer PF, Schlossberg SM (1999) Conservative surgical therapy for penile and urethral carcinoma. Urology 53:386–392PubMedCrossRef

25.

Di Giacomo AM, Ascierto PA, Pilla L, Santinami M, Ferrucci PF, Giannarelli D, Marasco A, Rivoltini L, Simeone E, Nicoletti SV, Fonsatti E, Annesi D, Queirolo P, Testori A, Ridolfi R, Parmiani G, Maio M (2012) Ipilimumab and fotemustine in patients with advanced melanoma (NIBIT-M1): an open-label, single-arm phase 2 trial. Lancet Oncol 13:879–886PubMedCrossRef

26.

DiMarco DS, DiMarco CS, Zincke H, Webb MJ, Keeney GL, Bass S, Lightner DJ (2004) Outcome of surgical treatment for primary malignant melanoma of the female urethra. J Urol 171:765–767PubMedCrossRef

27.

Calcagno L, Casario A, Bandelloni R, Gambini C (1991) Primary malignant melanoma of male urethra. Urology 37:366–368PubMedCrossRef

28.

Geelhoed GW, Myers GH (1973) Primary melanoma of the male urethra. J Urol 109:634–637PubMed

29.

Elisa A, Bannwart F, Maurer R, Ruedi P (1994) Primary malignant melanoma of the male urethra (Article in German). Case report and discussion of the literature. Praxis 83:1157–1160PubMed

30.

Flaherty KT, Infante JR, Daud A, Gonzalez R, Kefford RF, Sosman J, Hamid O, Schuchter L, Cebon J, Ibrahim N, Kudchadkar R, Burris HA 3rd, Falchook G, Algazi A, Lewis K, Long GV, Puzanov I, Lebowitz P, Singh A, Little S, Sun P, Allred A, Ouellet D, Kim KB, Patel K, Weber J (2012) Combined BRAF and MEK inhibition in melanoma with BRAF V600 mutations. N Engl J Med 367:1694–1703PubMedCentralPubMedCrossRef

31.

Filipkowski LA, Barker MA, Karram MM (2009) Primary genitourinary melanoma presenting as voiding dysfunction. Int Urogynecol J Pelvic Floor Dysfunct 20:1141–1143PubMedCrossRef

32.

Fujimoto N, Oda M, Shimoe S (1991) Primary malignant melanoma of the male urethra. Urol Int 47:176–177PubMedCrossRef

33.

Geisler JP, Look KY, Moore DA, Sutton GP (1995) Pelvic exenteration for malignant melanomas of the vagina or urethra with over 3 mm of invasion. Gynecol Oncol 59:338–341PubMedCrossRef

34.

Ginchermann Y, Weiss J, Elder D, Hamilton R (1996) A unique case of long-term survival in a male patient with malignant melanoma of the distal urethra. Cutis 57:44–46

35.

Gillenwater JY, Burros HM (1968) Unusual tumors of the female urethra. Obstet Gynecol 31:617–620PubMedCrossRef

36.

Girgin C, Tarhan H, Sezer A, Ermete M, Gürel G (1999) A large primary malignant melanoma of the female urethra. Urol Int 63:198–200PubMedCrossRef

37.

Girgis AS, Bergman H, Rosenthal H, Solomon L (1973) Unusual penile malignancies in circumcised Jewish men. J Urol 110:696–702PubMed

38.

Heslinga JM, Lycklama a, Nijeholt GA, Ruiter DJ (1986) Primary melanoma in the female distal urethra. Eur Urol 12:446–447PubMed

39.

Ito K, Matsuo Y, Takahashi O, Yajima H, Yamanaka H, Ito H (1999) Synchronous malignant melanoma of the male bulbar urethra and transitional cell carcinoma of the bladder. BJU Int 84:877–878PubMedCrossRef

40.

Iversen K, Robins RE (1980) Mucosal malignant melanomas. Am J Surg 139:660–664PubMedCrossRef

41.

Iyer KM, Shah AL, Bapat RD, Patel CV (1974) Primary malignant melanoma of the male urethra. Indian J Cancer 11:213–214PubMed

42.

John G, Williams JR, Johnson CE, Charlton CA (1992) Primary malignant melanoma of the male urethra. Br J Urol 69:212–213PubMedCrossRef

43.

Katz EE, Suzue K, Wille MA, Krausz T, Rapp DE, Sokoloff MH (2005) Primary malignant melanoma of the urethra. Urology 65:389PubMedCrossRef

44.

Katz JI, Grabstald H (1976) Primary malignant melanoma of the female urethra. J Urol 116:454–457PubMed

45.

Kim CJ, Pak K, Hamaguchi A, Ishida A, Arai Y, Konishi T, Okada Y, Tomoyoshi T (1993) Primary malignant melanoma of the female urethra. Cancer 71:448–451PubMedCrossRef

46.

Kokotas NS, Kallis EG, Fokitis PJ (1981) Primary malignant melanoma of male urethra. Urology 18:392–394PubMedCrossRef

47.

Konigsberg HA, Gray GF (1976) Benign melanosis and malignant melanoma of penis and male urethra. Urology 7:323–326PubMedCrossRef

48.

Kubo H, Mivawaki I, Kawagoe M, Kuriwaki K, Hatanaka S, Tanaka K, Nakagawa M (2002) Primary malignant melanoma of the male urethra. Int J Urol 9:268–271PubMedCrossRef

49.

Lefrancq T, Badoual C, Body G, Machet MC, Perrotin F, Lhuintre Y (1998) Desmoplastic recurrence of a melanoma of the female urethra (Article in French). Ann Pathol 18:203–205PubMed

50.

Lez C, Altarac S, El-Safadi S, Fures R, Cupic H, Persec Z, Hrgovic Z (2012) Primary malignant melanoma of the female urethra. J Med Cases 3:73–75

51.

Limburg H (1956) Clinical aspects and pathology of rare cases of malignant melanoma of vagina and urethra (Article in German). Geburtshilfe Frauenheilkd 16:75–79PubMed

52.

Lopez JI, Angulo JC, Ibanez T (1993) Primary malignant melanoma mimicking urethral caruncle. Case report. Scand J Urol Nephrol 27:125–126PubMedCrossRef

53.

Losappio M, Manneschi L (1981) Primary melanoma of the female urethra. Personal case and review of the literature (Article in Italian). Arch De Vecchi Anat Patol 64:521–527PubMed

54.

Lüchtrath H, Schmich HR (1984) Malignant melanoma of the penile fossa navicularis (Article in German). Urologe A 23:285–287PubMed

55.

Macro Perez LM, Torrecilla Ortiz C, Roig Sanz M, Rui Fernando F, Riera Canals L, Serrallach Mila N (1997) Primary adenoma of the female urethra (Article in Spanish). Actas Urol Esp 21:617–619PubMed

56.

Manivel JC, Fraley EE (1988) Malignant melanoma of the penis and male urethra: 4 case reports and literature review. J Urol 139:813–816PubMed

57.

Mayer R, Fowler JE Jr, Clayton M (1987) Localized urethral cancer in women. Cancer 60:1548–1551PubMedCrossRef

58.

Mcburney RP, Bale GF (1955) Primary malignant melanoma of the female urethra. Surgery 37:973–978PubMed

59.

Methfessel HD, Bettzieche H, Methfessel G (1983) Melanoma of the female urethra (Article in German). Zentralbl Gynakol 105:796–800PubMed

60.

Morita T, Suzuki H, Goto K, Hirota N, Tokue A (1991) Primary malignant melanoma of male urethra with fistula formation. Urol Int 46:114–115PubMedCrossRef

61.

Nakamoto T, Inoue Y, Ueki T, Niimi N, Iwasaki Y (2007) Primary amelanotic malignant melanoma of the female urethra. Int J Urol 14:153–155PubMedCrossRef

62.

Nissenkorn I, Servadio C, Avidor I, Marshak G (1987) Malignant melanomas of female urethra. Urology 29:562–565PubMedCrossRef

63.

Novák P, Strmiska M (1980) Melanoblastoma of the female urethra. Int Urol Nephrol 12:43–45PubMedCrossRef

64.

Oldbring J, Mikulowski P (1987) Malignant melanoma of the penis and male urethra. Report of nine cases and review of the literature. Cancer 59:581–587PubMedCrossRef

65.

Ornellas AA, Khouri FR, Campos F, Koifman N, Quirino R (1999) Cancer of the urethra in women: experience of the National Institute of Cancer of Brazil: 1992–1997 (Article in French). Prog Urol 9:292–298PubMed

66.

Ostergard DR, Townsend DE (1968) Malignant melanoma of the female urethra treated by cryosurgery with radical vulvectomy and anterior exenteration. Report of a case. Obstet Gynecol 31:75–78PubMedCrossRef

67.

Oyabu Y, Eto K (1992) Primary malignant melanoma of the male urethra. Br J Urol 70:687–688PubMedCrossRef

68.

Piedimonte A, Aquinati A, Scalise A, Bertani A (2004) Occult primary melanoma of the urethra: a long-term survival case. Plast Reconstr Surg 114:618–619PubMedCrossRef

69.

Pillai KR, Kumari A, Augustine J, Amma NS, Nair MK (1995) Cytodiagnosis of primary malignant melanoma of the female urethra—a case report. Indian J Pathol Microbiol 38:103–108PubMed

70.

Poore RE, McCullough DL (1996) Urethral carcinoma. In: Gillenwater JY, Grayhalk JT, Howard SS (eds) Adult and Pediatric Urology. Mosby, Missouri

71.

Pow-Sang JM, Klimberg IW, Hackett RL, Wajsman Z (1988) Primary malignant melanoma of the male urethra. J Urol 139:1304–1306PubMed

72.

Primus G, Soyer HP, Smolle J, Mertl G, Pummer K, Kerl H (1990) Early ‘invasive’ malignant melanoma of the glans penis and the male urethra. Report of a case and review of the literature. Eur Urol 18:156–159PubMed

73.

Radhi JM (1997) Urethral malignant melanoma closely mimicking urothelial carcinoma. J Clin Pathol 50:250–252PubMedCentralPubMedCrossRef

74.

Rashid AM, Williams RM, Horton LW (1993) Malignant melanoma of penis and male urethra. Is it a difficult tumor to diagnose? Urology 41:470–471PubMedCrossRef

75.

Rikaniadis N, Konstadoulakis MM, Kymionis GD, Tsibloulis B, Peveretos P, Karakousis CP (1998) Long-term survival of a female patient with primary malignant melanoma of the urethra. Eur J Surg Oncol 24:607–608PubMedCrossRef

76.

Robutti F, Betta PG, Bellingeri M, Bellingeri D (1986) Primary malignant melanoma of the female urethral meatus. Eur Urol 12:62–63PubMed

77.

Rodríguez Antolín A, Miñana López B, Fernández Aparicio T, Passas Martínez J, Pamplona Casamayor M, Leiva Galvis O (1991) Melanoma in urology: our experience and review of the literature (Article in Spanish). Actas Urol Esp 15:361–365PubMed

78.

Rosai J (2004) Ackerman’s surgical pathology. Mosby, St. Louis

79.

Sánchez-Ortiz R, Huang SF, Tamboli P, Prieto VG, Hester G, Pettaway CA (2005) Melanoma of the penis, scrotum and male urethra: a 40-year single institution experience. J Urol 173:1958–1965PubMedCrossRef

80.

Sanders TJ, Venable DD, Sanusi ID (1986) Primary malignant melanoma of the urethra in a black man: a case report. J Urol 135:1012–1014PubMed

81.

Sanz Velez JI, Esclarin Duny MA, Abad Roger J, Abascal Agorreta M, Vera Alvarez J (1989) Melanoma of female distal urethra: apropos of a case (Article in Spanish). Actas Urol Esp 13:63–64PubMed

82.

Savran J, Sayer EA, Schradiack CE (1948) Primary malignant melanoma of female urethra. Am J Surg 75:743–745PubMedCrossRef

83.

Sharma SK, Dutta TK, Jain SK, Gupta CL, Rao K, Bapna BC (1980) Malignant melanoma of female urethra. Indian J Cancer 17:264–267PubMed

84.

Stein BS, Kendall AR (1984) Malignant melanoma of the genitourinary tract. J Urol 132:859–868PubMed

85.

Sugaya K, Yazaki T, Ishikawa S, Kanoh S (1983) A case of amelanotic malignant melanoma of the female urethra. Jpn J Clin Oncol 13:435–439PubMed

86.

Terada Y, Takayasu H (1976) Malignant melanoma of the male urethra. Br J Urol 48:390PubMedCrossRef

87.

Thum G, Wechsel HW, Merkel KH (1990) Primary malignant melanoma of the distal urogenital tract. Case report and review of the literature (Article in German). Urologe A 29:158–160PubMed

88.

Upton JR (1958) Report of a malignant melanoma of the vestibule and external urethral meatus in a woman 6 months pregnant. West J Surg Obstet Gynecol 66:199–203PubMed

89.

Urso C, Taddei GL (1991) Melanoma of the lower female urogenital tract (gynaecological melanoma) (Article in Italian). Pathologica 83:29–34PubMed

90.

Watanabe J, Yamamoto S, Souma T, Hida S, Takasu K (2000) Primary malignant melanoma of the male urethra. Int J Urol 7:351–353PubMedCrossRef

91.

Weiss J, Elder D, Hamilton R (1982) Melanoma of the male urethra: surgical approach and pathological analysis. J Urol 128:382–385PubMed

92.

Yoshida K, Tsuboi N, Akimoto M (1986) Primary malignant melanoma of female urethra: report of a case and review of the literature. Hinyokika Kiyo 32:105–111PubMed

Titel: Primary malignant melanoma of the urethra: a systematic analysis of the current literature
verfasst von: Samer El-Safadi
Rebecca Estel
Peter Mayser
Karsten Muenstedt
Publikationsdatum: 01.05.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 5/2014
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-013-3130-3

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Ambulantisierung: Erste Erfahrungen mit dem Hybrid-DRG

02.05.2024 DCK 2024 Kongressbericht

Die Hybrid-DRG-Verordnung soll dazu führen, dass mehr chirurgische Eingriffe ambulant durchgeführt werden, wie es in anderen Ländern schon länger üblich ist. Die gleiche Vergütung im ambulanten und stationären Sektor hatten Niedergelassene schon lange gefordert. Aber die Umsetzung bereitet ihnen doch Kopfzerbrechen.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Harninkontinenz: Netz-Op. erfordert über lange Zeit intensive Nachsorge

30.04.2024 Harninkontinenz Nachrichten

Frauen mit Belastungsinkontinenz oder Organprolaps sind nach einer Netz-Operation keineswegs beschwerdefrei. Vielmehr scheint die Krankheitslast weiterhin hoch zu sein, sogar höher als von harninkontinenten Frauen, die sich nicht haben operieren lassen.

Welche Übungen helfen gegen Diastase recti abdominis?

30.04.2024 Schwangerenvorsorge Nachrichten

Die Autorinnen und Autoren einer aktuellen Studie aus Griechenland sind sich einig, dass Bewegungstherapie, einschließlich Übungen zur Stärkung der Bauchmuskulatur und zur Stabilisierung des Rumpfes, eine Diastase recti abdominis postpartum wirksam reduzieren kann. Doch vieles ist noch nicht eindeutig belegt.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Springer Medizin

Abstract

Background

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2014

Association of homocysteine, vitamin B12, and folate with bone mineral density in postmenopausal women: a meta-analysis

Lymph node metastasis in patients with epithelial ovarian cancer macroscopically confined to the ovary: review of a single-institution experience

Achim Schneider: Primary, secondary and tertiary prevention of cervical cancer

Comparison of Iodine-125 seeds implantation and afterloading radiotherapy in murine models of human cervical cancer