Penile melanoma: a 20-Year analysis of six patients at the National Cancer Institute of Peru, Lima

Abstract

Melanoma of the urogenital tract is extremely rare, accounting for less than 0.1% of melanoma cases. The global literature currently describes only 220 cases of penile melanoma, most commonly located on the glans penis.ResultsPenile melanoma accounts for 0.7% of penile cancers and 0.18% of melanoma cases. The average patient age for the six cases we reviewed was 44.5 years. Three of these cases (50%) involved ulceration, one case (16.7%) involved lymphovascular invasion, and three cases (50%) involved mitosis ≥ 1 mm2 (0.38–4.7 mm). The average depth of invasion (Breslow) in the five cases that reported this measure was 2.1 mm (0.38–4.7 mm). Applying the American Joint Committee on Cancer tumour, node, metastases (AJCC TNM) staging system, one case was Tx (16.7%), two cases were T1 (33.3%), one case was T2 (16.7%), one case was T3 (16.7%), and one case was T4 (16.7%). Five cases (83.3%) involved wide local resection, and only one case involved partial penile amputation. Four cases (66.7%) involved primary bilateral inguinocrural lymphadenectomy, and only one of those four cases involved lymphatic metastatic disease. One case (16.7%) involved lymphatic recurrence at 12 months in a patient who survived 38 months. One case (16.7%) involved local recurrence at 13 months in a patient who has survived 53 months. Eighty per cent of these patients remain alive, with no evidence of disease after an average follow-up of 96.7 months.ConclusionPenile melanoma prognosis depends on the initial clinical stage of the disease. The risk of lymphatic involvement seems to be related to the same risk factors used to assess cutaneous melanoma. Clinicians can thus assess penile melanoma using the AJCC staging system. The use of sentinel lymph node biopsy to determine staging is also becoming more common and could replace prophylactic bilateral inguinal dissection.

Melanoma In Situ on the Penis Treated Using Mohs Micrographic Surgery: Slow Mohs and Local Flap Reconstruction

“…Penile in situ melanoma is a rare condition that initiates with the appearance of a pigmented lesion often located on the glans, 1 described by Muchinson et al in 1859, 3 yet, to this date there are almost 220 cases in literature. 1 Penile melanoma is a neuroectodermic layer melanocytes malignant transformation; 1 because it is located on penis, it could be considered as a mucous or CM.…”

“…Penile in situ melanoma is a rare condition that initiates with the appearance of a pigmented lesion often located on the glans, 1 described by Muchinson et al in 1859, 3 yet, to this date there are almost 220 cases in literature. 1 Penile melanoma is a neuroectodermic layer melanocytes malignant transformation; 1 because it is located on penis, it could be considered as a mucous or CM. 1 Then PM arising from penis or prepuce skin requires a thorough physical examination and treatment according to CM guidelines 1,4 ; however, PM arising from the glans, urinary meatus, urethra, balanopreputial sulcus, or the inner of prepuce are considered MM.…”

“…1 Penile melanoma is a neuroectodermic layer melanocytes malignant transformation; 1 because it is located on penis, it could be considered as a mucous or CM. 1 Then PM arising from penis or prepuce skin requires a thorough physical examination and treatment according to CM guidelines 1,4 ; however, PM arising from the glans, urinary meatus, urethra, balanopreputial sulcus, or the inner of prepuce are considered MM. 1,2 A high percentage of MM are located in the glans (55%), 28% are localized in the urinary meatus, and 9% in the balanopreputial sulcus.…”

“…1–3 Second most frequent location is the urethra (36%), followed by foreskin and frenulum (9.1%)(I). In the penile skin melanomas group, 28% are localized in the foreskin and 9% on the penile body skin, 1 starting as a pigmented, painless lesion, with increasing size and occasional ulceration. 1 This ulceration can occur in 39% to 66% of the cases.…”

Transformation of Malignant Melanoma From Giant Nevus in Infantile Penis

“…The patient in this study developed primary cancer in the penis, but cancer invasion to the genital area was not reported. Melanoma in the urogenital tract rarely develops in individuals at any age: it has been reported in only 0.7% of penile cancer cases and only 0.18% of all melanoma cases ( 9 ). We reviewed all case reports on infantile malignant melanoma ( Supplementary Table 1 ).…”