Penile melanoma (case description)

Background. In recent decades, there has been a significant “rejuvenation,” an increase in the malignant potential of melanoma, particularly penile melanoma, which accounts for approximately 1% of all melanoma cases and <4% of urinary tract malignancies. The purpose of the work is to describe a rare case of penile melanoma. Methods. Pathomorphological examination of tumor tissue (surgical material) using histological and immunohistochemical methods. Results. A tumor was detected in a 55-year-old patient who had not sought help for 2 years. The neoplasm was radically removed and after a morphological examination, the diagnosis was made: Melanoma of the head of the penis (nodular form), p T2 N2 M0, stage III, with bilateral metastases in the inguinal lymph nodes. In order to finally verify the genesis of tumor cells, immunohistochemical reactions with antibodies to the antigenic determinants of HMV-45 and Melan-A were used. In the differential diagnosis of nodular melanoma, metastasis of melanoma of another location, nevoid melanoma was excluded (in addition to the other three classic histological variants). Conclusion. The peculiarities of this case include the combination of a number of unfavorable prognostic factors (large tumor size, significant depth of invasion, high mitotic index and cellular atypism, the presence of metastases in regional lymph nodes) with positive aspects (radical removal of the tumor node, intensive lymphocytic infiltration), which requires careful clinical observation and individual approach when choosing treatment tactics.