title: Primary malignant melanoma of the female urethra.
abstract: BACKGROUND
  Malignant melanoma is one of the rarest tumors of the female urethra. The prognosis of urethral melanoma is poor.
  
  
  METHODS
  A 59-year-old woman underwent total urethrectomy, bilateral inguinal lymph node dissection, and vesicostomy for Stage A primary malignant melanoma of the urethra. She received adjuvant therapy consisting of dacarbazine, vincristine, cyclophosphamide, and alpha-interferon. Two years later, repair of the parastomal hernia and interposition of an isoperistaltically ileum intussusception between the bladder and the abdominal wall were done.
  
  
  RESULTS
  Complete continence was achieved, and the patient catheterizes herself every 3-5 hours during the day and once at night without difficulty. She has survived 5 years without any evidence of tumor recurrence.
  
  
  CONCLUSIONS
  There have been only six case reports of women with primary malignant melanoma of the urethra surviving more than 5 years, including this case. Total urethrectomy with bilateral inguinal lymph node dissection should be done as the initial form of the treatment in patients with this disease who have no evidence of distant metastasis. The postoperative adjuvant therapy, consisting of alpha-interferon and chemotherapy, should be administered immediately; therefore, vesicostomy was done because it is a simple procedure. However, this type of urinary diversion requires an external appliance. Clinicians should consider the patient's quality of life, prognosis, and general condition and attempt to solve the problems of patients 2-3 years after the operation.
authors.affiliation: Department of Urology, Shiga University of Medical Science, Otsu, Japan.
authors.forename: C J
authors.initials: CJ
authors.lastname: Kim
authors.forename: K
authors.initials: K
authors.lastname: Pak
authors.forename: A
authors.initials: A
authors.lastname: Hamaguchi
authors.forename: A
authors.initials: A
authors.lastname: Ishida
authors.forename: Y
authors.initials: Y
authors.lastname: Arai
authors.forename: T
authors.initials: T
authors.lastname: Konishi
authors.forename: Y
authors.initials: Y
authors.lastname: Okada
authors.forename: T
authors.initials: T
authors.lastname: Tomoyoshi
mesh_terms: D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008545:Melanoma / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D014523:Urethral Neoplasms / Q000473:pathology / Q000628:therapy*