Melanoma of the female urethra

Abstract

Melanoma is a malignant tumor that can affect any area of the anatomical economy. Its appearance in the female urethra is extremely rare, with approximately 121 cases in indexed literature since 1966. The subject to be described is an 86-year-old woman who seeks assessment for intermittent macroscopic hematuria with blood clots of 3 months progression. On physical examination, there are no suspicious lesions detected on the surface of the skin. On external genital examination, it is observed a friable lesion at the level of the urethral meatus, with heterogeneous digitations, dark brown to black, and irregular polycyclic borders. No inguinal adenomegalies were palpated. Cystourethroscopy and biopsy of the lesion confirm the diagnosis. Melanoma of the female urethra is an extremely infrequent pathology. Due to lack of published case reports and the absence of prospective randomized trials on treatment outcomes, treatment must be directed using the same anatomical and surgical criteria for female urethral tumors, adding also the concepts of treatment of mucosal melanoma, even though its prognosis is different from the before mentioned.

Primary Malignant Melanoma of Female UrethraA Case Report

“…The TNM classification by AJCC on cancer is useful for clinical staging although for staging from a depth point, Chung's Index is more useful, which is applied in mucosal melanoma (Level 1: Limited to the epithelium, level 2: Less than 1 mm, level 3: Between 1 and 2 mm, and level 4: Over 2 mm of depth). [8] The treatment recommendations primarily depend on the tumor location and the clinical stage. The treatment varies from local excision with or without the addition of radiation therapy to extensive surgery, including cystourethrectomy, vaginectomy, vulvectomy, and lymph node dissection.…”

“…It seems however, unlike cutaneous melanoma, prognostic factors such as depth of tumor invasion or tumor stage do not appear to have that much of an impact at predicting survival in mucosal localized melanoma, mostly because its growth is usually nodular. [5,8]…”

Preliminary Results on Clinicopathological and Immunohistochemical Features of Malignant Melanomas

“…In the light of our results, which showed a slight predominance of females compared to males (M:F = 1:1.2) and the predominance of lower limb cutaneous PMs in females, and trunk PMs in males, respectively, there are authors who revealed the importance of sunlight exposure in the pathogensis of PMs of the skin [12]. Apart from the skin and choroidal plexus, primary malignant melanomas are rare at the other sites, these being reported in the literature mainly as case presentations [3,5,7]. Th e prognosis of cutaneous PM depends on the microscopic type of tumor (nodular vs. superfi cial), Breslow index, presence of ulceration, the status of sentinel lymph nodes and tumor stage [9,[13][14][15][16].…”

“…In most of the cases, malignant melanomas (MMs) aff ect the skin, but they can be also located in the choroid, nasal cavity, gastrointestinal and even the urogenital tract [1][2][3][4][5][6][7]. Despite the newest targeted drugs, such as monoclonal BRAF-inhibitors, MM remains the most deadly malignant tumor of the skin, with an increasing incidence [8].…”

Assessing the Patient with Abdominal Obesity: Metabolic and Nutritional Factors

“…Th e nutritional evaluation has to be a part of every general consultation, but it is time consuming and diffi cult to accomplish. Various tools are available [4,5] but none of them are fail-proof and it is recommended to use 2 or more for a complete image. Food frequency questionnaires are one of the best available methods for nutritional evaluation and they are used in national surveys as well [6].…”