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Malignant melanoma of the urethra: a rare histologic subdivision of vulvar cancer with a poor prognosis.

Günther V, Alkatout I, Lez C, Altarac S, Fures R, Cupic H, Persec Z, Hrgovic Z, Mundhenke C - Case Rep Obstet Gynecol (2012)

Bottom Line: In this paper, we present the case of a 65-year-old woman who was referred to a gynaecologist because of a urethral mass that mimicked a caruncle.Distal urethrectomy was performed after three months with no evidence of residual tumour.There was no evidence of disease at a six-year followup.

View Article: PubMed Central - PubMed

Affiliation: Department of Gynaecology and Obstetrics, University of Kiel, 24105 Kiel, Germany.

ABSTRACT
Malignant melanoma of the urethra is a rare tumour that is difficult to diagnose and treat, resulting in a poor prognosis. In this paper, we present the case of a 65-year-old woman who was referred to a gynaecologist because of a urethral mass that mimicked a caruncle. The tumour was removed by local excision, and a pathological analysis revealed a malignant melanoma. Distal urethrectomy was performed after three months with no evidence of residual tumour. There was no evidence of disease at a six-year followup. In this paper, we compare the epidemiology, treatment, staging, and prognosis of vulvar cancer in general to malignant melanoma of the vulva in particular.

No MeSH data available.


Related in: MedlinePlus

Polypoid, partially ulcerated melanoma of the female urethra (haematoxylin and eosin stain ×40).
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fig1: Polypoid, partially ulcerated melanoma of the female urethra (haematoxylin and eosin stain ×40).

Mentions: A 65-year-old woman was referred to a gynaecologist for a urethral mass that on gross examination appeared to be a caruncle. Upon examination, a 3-cm wide, pedunculated, black pigmented, friable, haemorrhagic polyp was found at the posterior wall of the urethral meatus. The tumour was removed by local excision. A histopathologic analysis partially revealed a polypoid tumour with superficial ulceration that comprised squamous and transitional epithelia (Figure 1). The tumour was composed of loosely cohesive nests of atypical epithelioid and spindle-shaped melanocytes that showed diffuse and nested growth patterns. The neoplastic cells had an abundant eosinophilic cytoplasm, large hyperchromatic nuclei with prominent nucleoli, and brisk mitotic activity. Most of the tumour cells contained coarsely granular melanocytic pigment (Figure 2). The depth of tumour invasion, as measured by a digital microscopic camera (Olympus DP10), was 3.57 mm. No vascular/lymphatic invasion was observed histologically. Immunohistochemically, the tumour cells showed strong cytoplasmic reactivity for HMB-45 and S100 (Figure 3). Three months after the initial surgery, a resection of the distal third of the urethra showed no evidence of disseminated disease. The initial staging, which included computerised tomography (CT) of the chest, abdomen, and pelvis, revealed no evidence of disseminated disease. A repeat CT of the chest, abdomen, and pelvis two years after the initial diagnosis revealed two enlarged right parailiac lymph nodes, which remained unchanged at two subsequent CT assessments that were performed four and six years after the primary diagnosis. The patient showed no evidence of disease during a six year follow-up period.


Malignant melanoma of the urethra: a rare histologic subdivision of vulvar cancer with a poor prognosis.

Günther V, Alkatout I, Lez C, Altarac S, Fures R, Cupic H, Persec Z, Hrgovic Z, Mundhenke C - Case Rep Obstet Gynecol (2012)

Polypoid, partially ulcerated melanoma of the female urethra (haematoxylin and eosin stain ×40).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539382&req=5

fig1: Polypoid, partially ulcerated melanoma of the female urethra (haematoxylin and eosin stain ×40).
Mentions: A 65-year-old woman was referred to a gynaecologist for a urethral mass that on gross examination appeared to be a caruncle. Upon examination, a 3-cm wide, pedunculated, black pigmented, friable, haemorrhagic polyp was found at the posterior wall of the urethral meatus. The tumour was removed by local excision. A histopathologic analysis partially revealed a polypoid tumour with superficial ulceration that comprised squamous and transitional epithelia (Figure 1). The tumour was composed of loosely cohesive nests of atypical epithelioid and spindle-shaped melanocytes that showed diffuse and nested growth patterns. The neoplastic cells had an abundant eosinophilic cytoplasm, large hyperchromatic nuclei with prominent nucleoli, and brisk mitotic activity. Most of the tumour cells contained coarsely granular melanocytic pigment (Figure 2). The depth of tumour invasion, as measured by a digital microscopic camera (Olympus DP10), was 3.57 mm. No vascular/lymphatic invasion was observed histologically. Immunohistochemically, the tumour cells showed strong cytoplasmic reactivity for HMB-45 and S100 (Figure 3). Three months after the initial surgery, a resection of the distal third of the urethra showed no evidence of disseminated disease. The initial staging, which included computerised tomography (CT) of the chest, abdomen, and pelvis, revealed no evidence of disseminated disease. A repeat CT of the chest, abdomen, and pelvis two years after the initial diagnosis revealed two enlarged right parailiac lymph nodes, which remained unchanged at two subsequent CT assessments that were performed four and six years after the primary diagnosis. The patient showed no evidence of disease during a six year follow-up period.

Bottom Line: In this paper, we present the case of a 65-year-old woman who was referred to a gynaecologist because of a urethral mass that mimicked a caruncle.Distal urethrectomy was performed after three months with no evidence of residual tumour.There was no evidence of disease at a six-year followup.

View Article: PubMed Central - PubMed

Affiliation: Department of Gynaecology and Obstetrics, University of Kiel, 24105 Kiel, Germany.

ABSTRACT
Malignant melanoma of the urethra is a rare tumour that is difficult to diagnose and treat, resulting in a poor prognosis. In this paper, we present the case of a 65-year-old woman who was referred to a gynaecologist because of a urethral mass that mimicked a caruncle. The tumour was removed by local excision, and a pathological analysis revealed a malignant melanoma. Distal urethrectomy was performed after three months with no evidence of residual tumour. There was no evidence of disease at a six-year followup. In this paper, we compare the epidemiology, treatment, staging, and prognosis of vulvar cancer in general to malignant melanoma of the vulva in particular.

No MeSH data available.


Related in: MedlinePlus