Primary urethral melanoma treated sucessfully with wide excision and combination immunotherapy: Case report and review of literature

Abstract

We report the rare case of a primary malignant melanoma of the urethra. An 89-year-old African American woman who was referred to our urology clinic for intermittent gross hematuria and a palpable vaginal mass of two months duration. Cystoscopy revealed a 3 cm mass in the distal urethra and urethral meatus that was surgically resected by wide local excision. The histopathologic diagnosis was primary malignant melanoma of the urethra. The patient was subsequently treated with adjuvant EBRT and immunotherapy with nivolumab and ipilimumab. Post-treatment PET-CT showed good response to treatment and patient remained in remission at eight month follow up.

Primary malignant melanoma of the male urethra: Case report and review of literature

“…Despite strict and aggressive adherence to surgery and immunotherapy with Pembrolizumab, the disease seemed intractable and recurred after 5 months, ultimately leading to the patient's death after 18 months. Two recently published case reports using immunotherapy to successfully treat urethral melanoma, an 89-year-old female patient with primary urethral melanoma with lymph node metastasis treated with extensive local resection, EBRT, and adjuvant combination immunotherapy, nivolumab (PD-1 inhibitor) and ipilimumab (CTLA-4), who responded well to treatment after 8 months [ 19 ], a 65-year-old man after receiving more than 10 cycles of nivolumab, FDG accumulation was no longer observed on PET-CT, with no recurrence 20 months after nivolumab treatment [ 20 ].…”