Melanosis of bladder: A rare entity

Area of Science:

• Urology
• Pathology
• Oncology

Background:

• Melanosis of the bladder (melanosis vesicae) is a rare condition characterized by pigment deposition in the bladder mucosa.
• It can be misdiagnosed as primary or metastatic melanoma, leading to unnecessary interventions.
• Understanding melanosis vesicae is crucial for accurate diagnosis and patient management.

Observation:

• A case of melanosis of the bladder is presented in a 69-year-old male patient.
• The patient had a history of prolonged lower urinary tract symptoms (LUTS) and bladder diverticulae.
• Cystoscopic examination revealed distinct black patches on the bladder mucosa.

Findings:

• Biopsy confirmed the presence of pigment within the bladder epithelium and underlying lamina propria.
• Special stains positively identified the pigment as melanin.
• Crucially, no malignant cells were detected, confirming a benign process.

Implications:

• This case highlights the importance of differentiating melanosis vesicae from malignant melanoma.
• Accurate diagnosis of this benign entity prevents overtreatment and patient anxiety.
• Awareness of melanosis vesicae aids urologists and pathologists in avoiding misdiagnosis of bladder cancer.