原發性尿道惡性黑色素瘤: 罕見病例報告

康庭碩、陳俊吉

彰化基督教醫院 外科部 泌尿科

Primary malignant melanoma of the urethra: a rare case report

Ting-Shuo Kang, Chun-Chi Chen

Divisions of Urology, Department of Surgery, Changhua Christian Hospital

Introduction:

Primary malignant melanoma of the genitourinary system is extremely rare, accounting for less than 1% of all primary melanomas. The prognosis is generally poor due to delayed diagnosis and rapid disease progression. We report a case presenting with urethral and left inguinal masses, managed with surgical resection and adjuvant therapy.

Case presentation:

A 70-year-old male presented with a black mass at the urethral meatus accompanied by a weak urinary stream for approximately three months. He initially sought medical attention at a local clinic, where a urethral biopsy was performed. The pathology report indicated suspected melanoma. He subsequently visited our urology outpatient department for a second opinion.

Cystoscopy revealed multiple black masses in the distal urethra, and repeat biopsy confirmed malignant melanoma. Whole-body positron emission tomography (PET) demonstrated metastatic lymph nodes in the left inguinal region. The patient underwent partial penectomy with left inguinal lymph node dissection. Adjuvant chemotherapy with dacarbazine was administered.

Four months after completion of chemotherapy, recurrent metastatic lymphadenopathy in the left inguinal region was detected. The patient then received radiotherapy followed by surgical resection. He has been followed regularly and remains free of disease recurrence for three months.