A melanin-synthesizing tumor of the urinary bladder was studied by light and electron microscopy. Careful clinical evaluation did not reveal evidence for a primary melanoma elsewhere in the patient. The clinical presentation, course of the disease, and demonstration of melanocytes in the bladder epithelium and malignant melanocytes comprising the tumor by light and electron microscopy indicated that the neoplasm was a primary malignant melanoma arising in the bladder.

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Since 1971, a prospective treatment regimen for primary cutaneous malignant melanoma performed by a single clinician has revealed the following early observations: 1) A significantly higher number of females with level II disease; 2) No recurrences or metastases to date in 29 patients with level II lesions treated by appropriate surgery; 3) The apparent clinical predictability of lymph node metastases in the group microstaged at level III. 4) An inability to predict lymph node metastases (or their delayed development) in patients with level IV disease; 5) A correlation between lymph node metastases and the development of disseminated disease.