Feasibility of Penis-Preserving Surgery for Urethral Melanoma: Proposal for a Therapeutic Algorithm

The objective is to perform a case report of primary melanoma of urethra in a male patient from a Teaching Hospital in Campinas, SP - Brazil. Male, 79 years of age, with blackened lesion on the meatus of the urethra with 1.5 cm of dimension, that could be palpated on the fossa navicularis region associated to an irregular lesion on the region of and the foreskin. The biopsy showed a malignant neoplasia. A partial penectomy with oncological margin of 2 cm was performed with a bilateral deep inguinal linfadenectomy. A follow up showed no recurrence of the disease.

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“…Concerns about the preservation of anatomical structures and sexual function represent a limitation to the wide surgical margins. 4 …”

Section: Discussionmentioning

confidence: 99%

Localized primary melanoma of male urethra with a 4-year follow up

Burity¹,

Linica

Saade

et al. 2021

Urology Case Reports

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“…Moreover, for both early invasive and in situ stages involving the glans and urethra, technical repair options are limited to case-adapted surgical strategies and surgeon’s skill [ 4 , 5 ]. One-stage reconstructive approaches have been reported but without a proper follow-up [ 6 ]. Uniformly, it is reported that at least a 5 mm safety margin from the visually apparent disease should be considered adequate and permits a partial glans sparing in most cases, but in the case of irregular and lightly colored flat lesions involving both glans and urethra this conventional limit may be unsafe [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Two-stage functional and aesthetic reconstructive surgery in melanoma in situ of the glans penis and urethra

Campodonico

Capponi

Ennas

et al. 2021

Cent european J Urol

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Melanoma in situ including glans penis and fossa navicularis is unique and represents a challenging dilemma since surgery should not be very aggressive. We present a case of melanoma in situ treated with a two-stage penile and urethral reconstructive surgery, with emphasis on functional and aesthetic results. At the first-stage surgery an anatomic glansectomy was perfomed, and combined preputial and full-thickness skin grafts were used to prepare the urethral plate and restore the aesthetic aspect of the corpora cavernosa. After 6 months, the distal urethra was repaired including the configuration of an orthotopic meatus and a neo-glans.

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“…However, population-based studies have shown that the histological subtype of urethral carcinoma does not appear to exert an impact on prognosis [1,2,8,9] . Nonetheless, it has to be acknowledged that urethral cancer is a rare disease for which therapeutic strategies still need to be better defined [12] . Though secondary urethral cancer after RC for BC is more frequent than concomitant urethral and BC it is difficult to draw meaningful conclusions for clinical practice owing to distinct differences in tumor biologic characteristics [13] .…”

Section: Discussionmentioning

confidence: 99%

Oncological Outcomes of Patients with Concomitant Bladder and Urethral Carcinoma

et al. 2016

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chronous BC was diagnosed in 13 (12%) patients, and the median follow-up was 21 months (interquartile range 4-48). Urethral cancers were of higher grade in patients with synchronous BC compared to patients with non-synchronous BC (p = 0.020). Patients with synchronous BC exhibited significantly inferior 3-year recurrence-free survival (RFS) compared to patients with non-synchronous BC (63.2 vs. 34.4%; p = 0.026). In multivariable analysis, inferior RFS was associated with clinically advanced nodal stage (p < 0.001), proximal tumor location (p < 0.001) and synchronous BC (p = 0.020). Conclusion: The synchronous presence of BC in patients diagnosed with urethral carcinoma has a significant adverse impact on RFS and should be an impetus for a multimodal approach. © 2016 S. Karger AG, Basel Key WordsBladder cancer · Lymph node · Prognosis · Radical cystectomy · Risk factor · Survival · Urethra Abstract Introduction: The study aimed to investigate oncological outcomes of patients with concomitant bladder cancer (BC) and urethral carcinoma. Methods: This is a multicenter series of 110 patients (74 men, 36 women) diagnosed with urethral carcinoma at 10 referral centers between 1993 and 2012. Kaplan-Meier analysis was used to investigate the impact of BC on survival, and Cox regression multivariable analysis was performed to identify predictors of recurrence. Results: Syn-

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Feasibility of Penis-Preserving Surgery for Urethral Melanoma: Proposal for a Therapeutic Algorithm

Cited by 10 publications

References 10 publications

Localized primary melanoma of male urethra with a 4-year follow up

Localized primary melanoma of male urethra with a 4-year follow up

Two-stage functional and aesthetic reconstructive surgery in melanoma in situ of the glans penis and urethra

Oncological Outcomes of Patients with Concomitant Bladder and Urethral Carcinoma

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