Zeighami Shahryar, Soltani Mohammmdreza, Khajeh Fatemeh, Ariafar Ali, Jahanabadi Zahra, Miladpour Behnoosh, Naghdi-Sede Nima
Uro-oncologist, Assistant Professor, Urology Department, Shiraz University of Medical Sciences, Shiraz, Iran.
Urologist, Uro-oncology Fellowship Student, Shiraz University of Medical Sciences, Urology Department, Fasa, Iran.
Qatar Med J. 2020 Apr 2;2020(1):11. doi: 10.5339/qmj.2020.11. eCollection 2020.
Malignant melanoma (melanoma) is a tumor of melanocytes that usually presents as cutaneous lesions. While melanoma can infrequently appear as a primary tumor elsewhere in the body, it is extremely rare in the urethra and even rarer as amelanotic malignant melanoma. We report the case of a 66-year-old male who presented with painless gross hematuria and lower urinary tract obstructive symptoms in the recent 2 weeks prior to his visit to our clinic. History and physical examination, including external genital examination, abdominopelvic sonography, and urine culture, were not conclusive. Cystourethroscopy revealed a creamy pink fragile mass located in the anterior proximal urethra that extended to the mid portion. Pathological examination of this lesion confirmed the diagnosis of amelanotic malignant melanoma using immunohistochemistry. Radical cystourethrectomy with ileal conduit was subsequently conducted. Although this tumor is extremely rare, urologists and pathologists should consider malignant melanoma as a diagnosis in patients with urethral tumor because of the likelihood of early metastasis and, consequently, poor prognosis. Complete surgical removal of the tumor and use of effective therapies can improve outcomes in these patients.
恶性黑色素瘤是一种黑素细胞肿瘤，通常表现为皮肤病变。虽然黑色素瘤很少会在身体其他部位以原发性肿瘤的形式出现，但在尿道极为罕见，而无色素性恶性黑色素瘤则更为罕见。我们报告了一例66岁男性患者，在前来我院就诊前的最近2周内出现无痛性肉眼血尿和下尿路梗阻症状。病史及体格检查，包括外生殖器检查、腹部盆腔超声及尿培养，均未明确诊断。膀胱尿道镜检查发现一个位于尿道近端前部、延伸至中部的乳脂状粉红色易碎肿物。对该病变进行病理检查，采用免疫组织化学方法确诊为无色素性恶性黑色素瘤。随后进行了根治性膀胱尿道切除术并留置回肠代膀胱。尽管这种肿瘤极为罕见，但由于其早期转移的可能性以及因此导致的预后不良，泌尿外科医生和病理科医生在诊断尿道肿瘤患者时应考虑恶性黑色素瘤。完整切除肿瘤并采用有效的治疗方法可改善这些患者的预后。
