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Clinical Images  |   September 2015
Primary Melanoma of the Urinary Tract
Author Notes
  • From the Department of Urology at the Charleston Area Medical Center in West Virginia. 
  •  *Address correspondence to Nathan Edward Hale, DO, Charleston Area Medical Center, 3110 MacCorkle Ave SE, Rm 58, Charleston, WV 25304-1210. E-mail: halene@upmc.edu
     
Article Information
Imaging / Urological Disorders / Clinical Images
Clinical Images   |   September 2015
Primary Melanoma of the Urinary Tract
The Journal of the American Osteopathic Association, September 2015, Vol. 115, 579. doi:10.7556/jaoa.2015.117
The Journal of the American Osteopathic Association, September 2015, Vol. 115, 579. doi:10.7556/jaoa.2015.117
An 83-year-old woman with a painful distal urethral mass presented to the urology department. Results of a cystoscopy revealed a 4-cm dark pigmented lesion in the bladder (image A). The patient was evaluated for a primary skin lesion or other primary malignancies, which was found to be negative. She underwent distal urethrectomy and transurethral resection of the bladder tumor, and HMB-45 and S-100 staining revealed melanoma of the urinary tract (image B). After this diagnosis, the patient underwent bladder preservation therapy with external beam radiation and close surveillance. This treatment delayed disease progression for 20 months, at which point the patient developed metastatic disease and elected to receive hospice care. Primary melanoma originating from the urinary tract is an extremely rare occurrence and requires extensive evaluation to exclude another primary site.1-4 
References
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