Urological Melanoma: A Comprehensive Review of a Rare Subclass of Mucosal Melanoma with Emphasis on Differential Diagnosis and Therapeutic Approaches
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Gerardo Cazzato
1,*,†
,
Anna Colagrande
1,†
,
Antonietta Cimmino
1,
Concetta Caporusso
1,
Pragnell Mary Victoria Candance
1,
Senia Maria Rosaria Trabucco
1,
Marcello Zingarelli
2,
Alfonso Lorusso
2,
Maricla Marrone
3,
Alessandra Stellacci
3,
Francesca Arezzo
4, 
Andrea Marzullo
1,
Gabriella Serio
1,
Angela Filoni
5,
Domenico Bonamonte
5,
Paolo Romita
5,
Caterina Foti
5,
Teresa Lettini
1,
Vera Loizzi
4, 
Gennaro Cormio
4,
Leonardo Resta
1
,
Roberta Rossi
1,‡ and
Giuseppe Ingravallo
1,‡
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1
Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
2
Section of Urology, Deparment of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
3
Section of Legal Medicine, Interdisciplinary Department of Medicine, Bari Policlinico Hospital, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
4
Section of Ginecology and Obstetrics, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
5
Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally.
‡
These authors contributed equally.
Cancers 2021, 13(17), 4424; https://doi.org/10.3390/cancers13174424
Submission received: 11 July 2021
/
Revised: 24 August 2021
/
Accepted: 30 August 2021
/
Published: 2 September 2021
(This article belongs to the Special Issue Study on the Complex Melanoma)
Simple Summary
Mucosal melanoma accounts for only about 1% of all melanoma cases worldwide, but achieving the correct recognition, diagnosis and prognosis is of extreme importance for the patient. Moreover, primary melanoma of the urinary tract is a rarity among rarities, accounting for less than 4% of all the mucosal melanomas. The urethra is the most common location for this type of melanoma, followed by the bladder and ureter with decreasing incidences. Patients with this form of melanoma are usually elderly (over 60 years) and asymptomatic or have hematuria symptoms. Compared to other mucosal melanomas, there is not much knowledge of the risk factors, etiology, and molecular characteristics of urological melanoma. In addition, there are no uniform staging systems or treatment protocols available for this disease. A thorough knowledge of the existence and management of this disease entity is essential to allow research advances in this area and, in particular, to devise innovative therapies. In this paper, we focus in detail on melanoma originating from the uropoietic apparatus, discuss the cases reported in literature of this very rare and still partially enigmatic melanoma subclass, and consider the scenario leading to metastasization to neighboring organs.
Abstract
Melanoma is reported as the 19th most common cancer worldwide, with estimated age-standardized incidence rates of 2.8–3.1 per 100,000. Although the origin is most frequently cutaneous, mucosal melanoma has been described several times in literature, and despite its rarity (only 1% of all melanomas), increasing attention is being paid to this disease form. Within this subgroup, melanomas of the uropoetic apparatus are a rarity among rarities. Indeed, less than 50 cases of primary melanoma originating from the urinary bladder have been described, and even less originating from the kidney, renal pelvis and urethra. In this work, we present a detailed review of the literature related to this subclass of mucosal melanoma, delve into the biological landscape of this neoplasm and discuss current approaches, future perspectives and potential therapeutic approaches.
Keywords:
melanoma; mucosal melanoma; urology
