Portuguese Scientists Report Rare Penile Melanoma
Scientists from Portugal reported a rare case of penile melanoma with aggressive biological behavior and poor prognosis. It involved a 65-year-old man with a pigmented nodular lesion on the glans. Histopathology confirmed the diagnosis, and lymph node involvement was also identified.
A case report titled “Not all penile tumours are alike: A rare case of penile melanoma” was published at the end of November in Urology Case Reports. The authors are Miguel Gil, José Cabrita Carneiro, Ana Meireles, and Luís Campos Pinheiro from the Department of Urology, Unidade Local de Saúde de São José, Lisbon, Portugal.
The researchers emphasized that penile cancer accounts for less than 1% of all cancer cases, with risk factors including human papillomavirus (HPV) infection, poor genital hygiene, and tobacco use.
Penile melanoma is among the rarest types of melanoma
Melanoma is a type of cancer that arises from pigment cells and most commonly appears on the skin, while forms on mucous membranes are very rare. Mucosal melanomas are not associated with sun exposure and usually have a more aggressive course. Penile melanoma is among the rarest types of melanoma and most often occurs in older men.
“Patients usually present with a painless, non-healing pigmented lesion that may be ulcerated. They are usually asymptomatic at earlier stages, which prevents early diagnosis. The most common site is the glans (55%), followed by the foreskin (28%), penile shaft (9%), and urethral meatus (8%),” the authors wrote in the study.
As they explained in detail, a 65-year-old man presented to the urology department with a lesion on his penis that had been growing for a year. It was a painless, progressively enlarging lesion on the glans. After several analyses, including disease staging, the patient underwent robot-assisted laparoscopic bilateral dissection of the inguinal and pelvic lymph nodes, which confirmed the presence of two lymph node metastases.
Treatment and further research
In this case, the patient was treated with a multimodal approach: surgical resection with negative margins, dissection of inguinal and pelvic lymph nodes, adjuvant radiotherapy, and nivolumab immunotherapy, which resulted in a favorable outcome and 15 months of disease-free follow-up.
Due to the rarity of this condition, a high index of suspicion is crucial for an accurate diagnosis. Penile melanoma has a poorer prognosis than cutaneous melanoma. As explained in the report, it is often diagnosed at an advanced stage, with a 5-year survival rate between 10% and 31%; therefore, increased awareness among patients and clinicians is important for early diagnosis and better outcomes.
“Multidisciplinary management is crucial, and multimodal treatment strategies are often required. Early detection remains the cornerstone for improving outcomes. Further research is needed to better understand its molecular biology, prognostic factors, and optimal treatment strategies,” the researchers concluded.
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