Suzuki Hiroaki, Nakanishi Yasukazu, Yoshino Koji, Kataoka Madoka, Fukushima Hiroshi, Tobisu Kenichi, Koga Fumitaka
Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital.
Department of Dermatology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital.
Nihon Hinyokika Gakkai Zasshi. 2018;109(2):111-115. doi: 10.5980/jpnjurol.109.111.
We report a case of primary malignant melanoma (MM) of the female urethra. A 60-year-old female complained bleeding from the urethral meatus. MRI revealed a mass of 20 mm at the external urethral meatus. Pathological examination of transurethrally resected specimens revealed MM with stromal invasion. She underwent total urethrectomy plus cystostomy and sentinel lymph node biopsy. The tumor was pathologically confined in the specimen and no lymph node metastasis was found. She received interferone β as adjuvant therapy. However, she developed bilateral adrenal and pulmonary hilar lymph node metastases 1 year after urethrectomy. Although she started to receive nivolumab as salvage therapy, the disease progressed as well as development of interstitial pneumonia (IP) after four cycles. Following improvement of IP with steroid therapy, she started to receive ipilimumab, which resulted in the development of intolerable IP of grade 3. The patient finally died of MM 19 months after the initiation of treatment.
我们报告一例女性尿道原发性恶性黑色素瘤（MM）。一名60岁女性主诉尿道口出血。MRI显示尿道外口有一个20mm的肿块。经尿道切除标本的病理检查显示为伴有基质浸润的MM。她接受了全尿道切除术加膀胱造瘘术和前哨淋巴结活检。肿瘤在病理上局限于标本中，未发现淋巴结转移。她接受了干扰素β作为辅助治疗。然而，尿道切除术后1年，她出现了双侧肾上腺和肺门淋巴结转移。尽管她开始接受纳武单抗作为挽救治疗，但四个周期后疾病进展并出现了间质性肺炎（IP）。在使用类固醇治疗使IP改善后，她开始接受伊匹单抗治疗，结果导致了3级难以耐受的IP。患者在治疗开始后19个月最终死于MM。
