Penile primary melanoma: analysis of 6 patients treated at Brazilian National Cancer Institute in the last eight years.
OBJECTIVE
To describe our experience in treating penile melanoma in 06 patients followed at our institution.


METHODS
Between 2004 and 2012 six consecutive patients with penile melanoma were treated at our Institution. Stage of the disease was classified according to the 2002 AJCC pathologic system. Melanoma in situ (TIS) was diagnosed in one patient. One patient was staged as T1b, two patients as T2b and two patients as T4b. The clinical and pathological findings were evaluated. Immunohistochemical tests were performed for Melan-A, HNB-45, S-100 and C-KIT. All histological specimens were examined by the same pathologist (ABSS). The patients with Cis, stages T1b and one patient T2b underwent only local excision. One patient T2b underwent local excision and sentinel lymph node dissection. Two patients with melanoma stage T4b underwent partial penile amputation. One of these last patients had palpable inguinal lymph nodes at diagnosis and underwent bilateral inguinal lymphadenectomy and received systemic chemotherapy (dacarbazine, 30 cycles).


RESULTS
Mean follow-up was 36.3 months. One patient, with stage T2b, died after 12 months due to disease recurrence with bilateral inguinal involvement. The patient who underwent chemotherapy progressed with lung metastases and died after 14 months of follow up. The disease-free survival at five years was 33.3%.


CONCLUSIONS
Penile melanoma is a disease with poor prognosis in most cases. Local excision or partial penile amputation may have effective control for stages T1 and T2 lesions. Patients who have clinically proven metastases died despite surgical and adjuvant chemotherapy.
Departments of Urology, Brazilian National Cancer Institute, Rio de Janeiro, RJ, Brazil.
Gustavo Ruschi
GR
Bechara
Aline Barros de Santos
AB
Schwindt
Antonio Augusto
AA
Ornellas
Diogo Eugênio Abreu da
DE
Silva
Felipe Monnerat
FM
Lott
Franz Santos de
FS
Campos
D000293:Adolescent; D000368:Aged; D001706:Biopsy; D001938:Brazil; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000628:therapy*; D008875:Middle Aged; D009367:Neoplasm Staging; D010412:Penile Neoplasms / Q000473:pathology* / Q000628:therapy*; D010413:Penis / Q000601:surgery