Melanoma of Urinary Bladder presented as acute urine retention

Abstract

This report is of a 50-year-old man with a rare urinary bladder melanoma. He presented with hematuria followed by bladder outlet obstruction at the time of presentation. Ultrasonogram of the pelvis revealed a mass in the bladder outlet, suggestive of enlarged prostate. Suprapubic cystostomy was then performed. Subsequent transvesical exploration revealed a dark coloured mass at the outlet of bladder, which on histopathology confirmed to be melanoma. After ruling out other possible primary sites, he underwent radical cysto-urethrectomy with urinary diversion. Disease was confirmed with immunohistochemistry. Patient died after 3 months with bilateral lung metastasis.

Primary melanoma of the bladder: case report and review of the literature

“…The symptoms caused by this tumor vary and depend on the location of the tumor 4 . The patient in our case complained of hematuria for one month.…”

“…Gross hematuria is one of the most frequent presenting symptoms, and it also occurs in patients with bladder tumors, and may manifest differently depending on the size and location of the tumor in the bladder. It was reported that recurrent urinary tract infections could be an initial symptom in some patients with primary bladder melanoma 4 .…”

“…Immunohistochemical staining is crucial to make an accurate diagnosis of this type of disease. Thus far, some diagnostic criteria for primary melanoma in bladder have been established as follows 5 : (1) absence of any previous skin lesions, (2) cutaneous malignant melanoma, (3) primary visceral malignant melanoma, (4) recurrence pattern showing consistency with the primary tumor diagnosis, ( 5) atypical melanocytes at the tumor margin upon microscopic examination.…”

Primary melanoma of the bladder: case report and review of the literature

“…The symptoms caused by this tumor vary and depend on its location [ 32 ]. The patient in our report complained of hematuria for 1 month.…”

Bladder-sparing Approach in a Woman with Muscle-invasive Primary Bladder Melanoma

“…Some authors have reported that recurrent urinary tract infections, could be a presenting feature in some patients with PBM. 4 The initial diagnosis was made by the detection of the tumor on cystoscopy and by taking tissue samples with TUR. It is recommended to obtain samples and evaluate them for the presence of atypical melanocytes in the peritumoral bladder mucosa.…”