Abstract: PD49-12
Sources of Funding: None

Introduction

Malignant melanoma of the female urethra is a rare tumor. There is limited data regarding management and outcomes of this condition. We therefore sought to evaluate the management and outcomes of urethral melanoma in females at our institution.

Methods

A retrospective analysis was performed of all women presenting to a tertiary referral center with primary malignant melanoma of the urethra from 1950 to 2016. All patients with identifiable metastatic disease at time of diagnosis were excluded. We evaluated pathology, tumor characteristics, presenting symptoms, initial and subsequent treatments, tumor recurrences, and survival.

Results

A total of 23 women (median age 71; range 51, 86) were identified with a pathologic diagnosis of malignant melanoma of the urethra. Median width of the urethral mass was 2.2 cm (IQR 1.4, 3.0) with a median depth of invasion of 7 mm (IQR 3, 12). The majority of masses involved the distal urethra (83%, 19/23), while four involved the entire urethra (17%). Concurrent vaginal involvement (pathologic T3) was present in 65% of patients (15/23). Reason for presentation to clinic include bleeding (74%, 17/23), mass (17% 4/23), pain (13%, 3/23), and voiding difficulty (4%, 1/23). All patients underwent surgical resection as first line therapy (65% partial urethrectomy, 26% radical urethrectomy, 9% anterior exenteration). Fifteen (65%) patients had recurrence of disease at a median of 7 months (IQR 4, 13). Local recurrence occurred in 80% of patients (12/15). Metastatic disease was identified in 60% of patients (9/15) with lungs being the most common site (78%, 7/9), followed by inguinal lymph nodes (44%, 4/9) and brain (33%, 3/9). Metastatic disease occurred at a median of 5 months (IQR 3, 25). A total of thirteen patients died secondary to melanoma (65%, 13/20). Median overall survival is 25 months (IQR 9, 53) and cancer specific survival is 53 months (IQR 12, 72).

Conclusions

Malignant melanoma of the urethra in females commonly recurs (65%) with a large proportion of those patients progressing to metastatic disease (80%) at a median of 5 months after initial surgical resection. These patients should be closely monitored for development of systemic disease with timely initiation of adjuvant therapies.

Funding

None