A Female Urethral Melanoma Treated with a Bladder Sparing Approach

Malignant melanoma rarely involves the genitourinary organs, however urethral involvement accounts for the majority of documented cases. In comparison to cutaneous melanoma, urethral melanoma is associated with a poor prognosis owing to the advanced stage at presentation. Treatment options are largely dictated by the extent of disease, however diagnostic and treatment recommendations are not clearly defined. Surgical options can range from distal urethrectomy, to radical cystectomy for those lesions involving the bladder neck. Although local control can be achieved with radical extirpative surgery, the effect on the patient's urinary control and the patient's quality of life are detrimental. In the following case, we present a 68-year-old Asian American woman with advanced urethral melanoma who was treated with distal urethrectomy, radical hysterectomy, and adjuvant chemotherapy. Using this multimodal treatment the patient was able to enjoy a satisfactory quality of life with no evidence of disease recurrence at two years after treatment.