Malignant melanoma of the glans penis and male urethra Glans penis ve erkek üretrasının primer malign melanomu

Abstract

CERRAHİ BİLİMLER / SURGICAL SCIENCESOlgu Bildirisi / Case Report P rimary MM of the penis and male urethra are uncommon neoplasms. MM of the urethral meatus, the glans penis, the prepuce and the penile shaft are cutaneous forms, while melanomas of the rest of the urethra are mucosal forms. The diagnosis is often delayed by the patient's reluctance to consult a physician and by the intrinsic difficulty of such a rare neoplasm. We present a case of malignant melanoma of glans penis and urethral meatus. Case reportThe patient, 73 years old, presented to the urology department of our hospital with pigmented plaque on his glans penis, which had been present for 1 year and rapidly increasing in the last 4 months. Physical examination revealed an approximately 1 cm diameter, unevenly black pigmented, poorly circumscribed, flat lesion on glans penis situated around the meatus externus and merges in the distal part of the urethra. Bilateral palpable inguinal lymphadenopathy was present. There was an approximately 0.5 cm diameter, soft nodule on the left side of the penile shaft (Figure 1). Chest radiography, sonography of the liver did not show evidence of metastatic disease, but bilateral inguinal lymph node metastases showed by computerized tomography of the lower abdomen. Incisinal biopsy was done to penile lesions and inguinal lenf node. The histologic diagnosis was: cutaneus lentiginous MM of the glans (Figure 2a, 2b), 5.64 mm in thickness, with multiple conglomeruleted lenf node metastasis. Patient refuse the all treatment modalities, and died six months later.Malignant melanoma (MM) of the penis is rare and accounts for a small percentage of malignant melanomas and of malignant penile lesions. The problem of the therapeutic approach is still unsolved. In general prognosis is poor and most patients die within a few years becouse of the distant metastasis.