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Metastatic malignant melanoma to the bladder: a case series
Eric S Wisenbaugh1, Melissa L Stanton1, Gwen M Grimsby1
1Mayo Clinic Arizona, Phoenix, Ariz., USA.
Background:
Metastatic melanoma to the bladder is rarely reported, and the role of surgery is still largely unknown. We review 4 such cases and highlight their management and outcomes. We also review the relevant literature.
Methods:
The Mayo Clinic tumor database was searched and 4 such cases were found.
Results:
All 4 patients were treated locally with transurethral resection. The only patient who had a solitary metastasis did relatively well, having no evidence of disease 10 months after his presentation, while the other 3 died within 6 months. The literature highlights various approaches to management, but there is no definitive evidence that radical cystectomy offers any benefit over transurethral resection.
Conclusion:
Resection may improve survival in the setting of a solitary metastasis, but there is no evidence that radical cystectomy offers any benefit over local resection. With diffuse disease, however, resection is likely only beneficial for treatment of hematuria.
Insights
Metastatic melanoma rarely spreads to the bladder. Surgery, like transurethral resection, may improve survival for solitary bladder metastases, but radical cystectomy offers no proven benefit over local resection.
Area of Science:
- Urology
- Oncology
- Surgical Oncology
Background:
- Metastatic melanoma to the bladder is an infrequent occurrence.
- The optimal surgical management for this condition remains unclear.
- This study reviews four cases to elucidate treatment outcomes.
Observation:
- Four cases of metastatic melanoma to the bladder were identified.
- All patients underwent local treatment via transurethral resection.
- One patient with a solitary metastasis achieved disease-free status at 10 months.
Findings:
- Solitary metastases showed improved survival post-resection.
- Three patients with diffuse disease died within six months.
- No definitive evidence supports radical cystectomy over transurethral resection for metastatic melanoma of the bladder.
Implications:
- Local resection may enhance survival in solitary metastatic melanoma to the bladder.
- Radical cystectomy does not appear to offer superior outcomes compared to local resection.
- For diffuse disease, surgical resection primarily addresses hematuria symptoms.
