The Rarest of Rare Penile Carcinomas: In Situ and Invasive Nodular Penile Melanomas on the Same Patient Clinical Case and Systematic Review

Introduction: Primary melanoma of the penile urethra and glans is a rare condition that accounts for less than 2% of all penile tumours,composes only 0.1% of total melanomas. Because of its great rarity, thisclinical case presentation is considered noteworthy for the scientific community, providing an exhaustive review of this pathology. Method: A literature search using PubMed search engine was conducted analysing latest reviews from the last 10 years using the terms “glans melanoma”. Only 18 results were found, most of them being published as case report. Second search is performed using the terms “urethra melanoma”, founding 7 review articles on the last 10 years in males. Although not all articles meet the requirements, and half of them are the same found in prior search. Finally, theoretical and epidemiology articles were selected in order to provide anatomical base and dermatological information. Results: 85-year-old male is diagnosed with melanoma in situ in glans and urethra by cold biopsy. The treatment includes total penectomywith perineal urethrostomyand bilateral inguinal laparoscopic lymphadenectomy. Conclusions: The risk factors for this type of pathology are not fully identified, so the follow-up of pigmented lesions in this area should be carried outby a specialist. Even though there is no consensus on melanoma, surgery is considered to be the first option with curative intention in localized tumours, though staging must be completed due their rapid dissemination and late diagnosis if there is no clinical suspicion. In the case of distant metastasis, the treatment does not differ from any other metastatic melanomas, where chemotherapy and immunotherapy are the cornerstone of the treatment.It is necessary to go in depth inthese clinical cases to elaborate clear guidelines for this pathology.