Bobin J Y, Gaude J M, Bailly C, Gérard J P, Mayer M
J Urol (Paris). 1983;89(2):105-9.
The authors report four cases of primary malignant melanoma of the urethra. The rarity of these lesions can lead to their mis-diagnosis. Only histological examination of a biopsy specimen stained with Fontana stain can confirm the diagnosis. These tumours have a very poor prognosis because of their tendency to locally invade the corpus cavernosus in men and the vulva and vagina in women. These lesions carry a high risk of lymph node and metastatic dissemination. For very limited tumours, the authors recommend a relatively extensive urethrectomy (2/3 of the urethra in women and amputation of the penis in men with a perineal urethrostomy) completed by interstitial irradiation with irridium 192 (6,000 rads) and inguinal lymphadenectomy. In larger tumours, with lymph node invasion, the very brief survival time makes extensive excision inappropriate. Limited palliative surgery is to be preferred. Radiotherapy and chemotherapy have no proven effectiveness.
作者报告了4例原发性尿道恶性黑色素瘤病例。这些病变较为罕见，可能导致误诊。只有对经Fontana染色的活检标本进行组织学检查才能确诊。由于这些肿瘤倾向于局部侵犯男性的海绵体以及女性的外阴和阴道，其预后非常差。这些病变存在淋巴结转移和远处转移的高风险。对于非常局限的肿瘤，作者建议进行相对广泛的尿道切除术（女性切除2/3的尿道，男性切除阴茎并行会阴尿道造口术），随后进行铱192组织间照射（6000拉德）和腹股沟淋巴结清扫术。对于较大的、伴有淋巴结侵犯的肿瘤，由于生存时间极短，广泛切除并不适宜。有限的姑息性手术更为可取。放疗和化疗尚未证实有效。
