Melanoma in situ of penis: a very rare entity

RATIONALE: Melanoma in situ of the penis is very rare and there are no clear guidelines for its surgical treatment. PATIENT CONCERNS: The authors describe the case of a 69-year-old man who presented with an asymptomatic brown macula on his glans penis and foreskin that appeared about 8 years earlier, enlarged in the last few months. DIAGNOSES: A diagnostic biopsy showed the characteristics of a melanoma in situ. INTERVENTIONS: The authors decided to excise the lesion keeping a healthy margin of 1 cm all over around except close to the urethral meatus, where it was impossible, and where only 5 mm of free margin was excised. A full thickness mucosal graft from oral cavity was performed to repair the defect. OUTCOMES: No recurrence or metastasis occurred during 50 months after the operation. LESSONS: Considering that at the sixth clinical follow-up the patient was alive and disease free at 50 months after surgery, the chosen treatment has proved successful.