Assessment of the clinical and morphological characteristics of primary extracutaneous melanomas

The objective of the study: Considering the significant effect that a melanoma diagnosis has regarding the life quality of the patients affected by this life-threatening disease, we wanted to contribute to a better understanding of the clinical and morphological characteristics of primary extracutaneous melanomas. Material and Methods: We performed a retrospective observational study with cases collected from the Pathology Department of “Pius Brînzeu” Emergency County Clinical Hospital. We identified all the cases with a melanoma diagnosis from the database, from January 2018 to December 2023 and then we extracted the primary extracutaneous melanomas. Results: From the 8 cases of extracutaneous primary melanomas identified, 5 were diagnosed as ocular melanomas (62.5%), 2 as anal mucosa melanomas (25%) and one as penile glans melanoma (12.5%). Regarding the ocular melanomas, 3 cases were diagnosed in female patients and 2 cases in male patients, median age 57.8 years (age range 50-70 years). One tumor was located in the choroid (pT3), one in the uvea and choroid (pT2a), one in the conjunctiva (pT1a) and 2 cases involved the ciliary body (pT4b and pT4e). Two of the cases (40%) presented extraocular extension. One of the patients with anal mucosa melanoma was previously diagnosed with poorly differentiated rectal adenocarcinoma and urinary bladder urothelial carcinoma (63 years, male). This patient presented to the hospital with abdominal pain. The macroscopic aspect of the anal melanoma was nodular. The other patient presented to the hospital with rectal bleeding (86 years, female). A stenosing tumour was described by endoscopy. The penile glans melanoma invaded the corpus spongiosum and extended along the urethra. The case also presented lympho-vascular invasion and an inguinal lymph node metastasis. The patient was previously diagnosed with an adenocarcinoma of the colon (78 years, male). Conclusions: The primary extracutaneous melanomas are very rarely diagnosed. The ocular melanomas were the most frequently diagnosed primary extracutaneous melanomas in our study.