Primary malignant melanoma of the female urethra − a case report

Introduction. Malignant melanoma accounts for 3% of all cancers in Europe. Malignant melanoma of the genitourinary tract is very rare, accounting for 1% of all cases. In addition, primary malignant melanoma of the urethra accounts for 0.2% of all melanomas and 4% of all urethral cancers. The abnormal migration of melanocytes during the embryonic development may explain their occurrence in the urethra. Also, vulva contains a relatively high concentration of melanocytes, so it may be the reason for higher incidence of malignant melanomas in females than in males, especially located at the meatus or in the distal urethra. Case Report. A 60-year-old woman presented with a solid tumor protruding through the vaginal introitus. Computerized tomography revealed a 5 cm large tumor of the urethra, infiltrating the bladder neck and the anterior vaginal wall. In addition, a bilateral pelvic lymphadenopathy was observed. The patient underwent anterior pelvic exenteration with urethrectomy, bilateral pelvic lymphadenectomy and bilateral ureterocutaneostomy, followed by immunochemotherapy. Nonetheless, the patient died 10 months after the surgery. Conclusion. Urethral melanoma is a tumor with a very poor prognosis and high recurrence rate (71%), even after wide surgical resection, adjuvant radiotherapy, chemo and immunotherapy.