Metástasis vesical de melanoma maligno: a
propósito de un caso.Authors:
Violeta Menéndez López, Ricardo Alvarezvijande
García, Manuel Solé Arqués Y Pablo
Arch. Esp. Urol., 55, 10 (1.277-1.279), 2002
Vol. 55, Number. 10, December 2002
OBJECTIVES: To report one case of malignant
melanoma metastasis into the urinary tract, diagnosed after excision
of the primary lesion.
METHODS: Case of a 75 year old male with history of malignant
melanoma in the scapular region excised 7 years before who presents
with lower urinary tract symptoms (LUTS), hematuria and a
hypogastric mass, 12 cm in diameter, located superficially and
anterior to the bladder. He underwent partial cystectomy for excision
of the mass, prostate adenomectomy and lithiasis extraction.
RESULTS: Pathological study showed neoplasic cell proliferation
with tendency to form sparse round nests or sheaths; cells had wide,
polygonal cytoplasms and occasionally melanocitic pigment. Protein
S-100 detection by Immunohistochemical tests was positive, being
the final diagnosis malignant melanoma metastasis.
CONCLUSIONS: Bladder metastatic disease is unusual and
rarely clinically evident. Nevertheless, it is frequent for bladder
metastases to be caused by melanoma. Bladder metastatic lesions
are rarely symptomatic, although approximately 15% of the cases
are symptomatic, being hematuria the most common presentation.
Although radical cystectomy seems to be the treatment of choice in
potentially curable patients with solitary metastasis, to date no
patient has survived more than three years, demonstrating the
aggressive natural history and ominous prognosis of this disease.