陰茎悪性黒色腫の1例

Abstract

We experienced a 53-year-old male with malignant melanoma of the penis. A lentigo was noted in the dorsal penis in 1980. On February 4, 1982, he was referred to our Hospital with the complaint of enlargement of the lentigo of the penis and swelling of the bilateral inguinal lymph nodes. Lymph node biopsy disclosed metastasis of the malignant melanoma. He was hospitalized for treatment of the lesion. On physical examination at admission, a black tumor, 3 cm in diameter, with necrosis at the center and unclear demarcation was observed in the dorsal part, very close to the coronal sulcus, slightly to the left. Many black spots were scattered around the tumor. Curative operation could not be expected because of metastasis to the lymph nodes and the lung. Combination chemotherapy with DTIC, ACNU and vincristine, and immunotherapy were carried out. CT scan, lymphangiography and intravenous pyelography confirmed right hydronephrosis due to compression of enlarged retroperitoneal lymph nodes. Agenesis of the left kidney was confirmed through these evaluations. Right ureterostomy was performed and a metastatic lesion was identified in the resected ureter. After the operative treatment, chemotherapy and immunotherapy were performed again, but their effects were limited, and he died on May 6, 1982. Metastatic lesions in the lungs, liver, brain, skin and agenesis of the left kidney were confirmed by autopsy. Eleven malignant melanomas of the penis including our case have been reported in the Japanese literature. This case is considered to be secondary to an ureter tumor.