Synchronous melanosis of upper and lower urinary tract

Area of Science:

• Urology
• Pathology
• Melanin Biology

Background:

• Urothelial melanosis is an extremely rare condition characterized by abnormal melanin deposition in the urinary tract lining.
• Less than 25 cases have been documented in medical literature, highlighting its rarity.

Observation:

• A 67-year-old male patient undergoing percutaneous nephrolithotomy (PCNL) was incidentally found to have a diffuse black, velvety appearance of the bladder mucosa during cystoscopy.
• The melanosis extended from the bladder up the ureter and into the renal pelvis.

Findings:

• This case represents the first documented instance of synchronous melanosis involving both the upper and lower urinary tracts.
• The findings expand the known spectrum of urothelial melanosis presentation.

Implications:

• This case broadens the understanding of urothelial melanosis, suggesting it can affect the entire urinary system.
• Further research may be needed to understand the etiology and long-term implications of widespread urothelial melanosis.