Malignant Melanoma of the Penis

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Abstract
Two cases of primary malignant melanoma of the penis are described, bringing the total number of cases reported in the literature to 36. The clinico-pathological aspects of this lesion have been discussed and the literature has been reviewed. Both patients presented with lesions involving the glans penis. The duration of symptoms was 2 and 3 months, respectively. Both patients were treated by total amputation of the penis and by dissection of the inguinal lymph nodes. Metastatic deposits were present in the inguinal lymph nodes in both cases. One patient died 6 months after presentation with local recurrence and evidence of distant metastases, while the other is alive and well 13 months after leaving hospital. Malignant melanoma of the penis usually occurs between the age of 50 and 80 years. The duration of symptoms, as well as the behaviour of the lesion, are variable. The most common presenting symptom is the presence of a dark nodule on the glans, which is enlarging and ulcerating. Histologically the lesion shows typical appearances of pigmented malignant melanoma. Spread of the tumour occurs via the lymphatics to the inguinal lymph nodes, and often occurs early in the course of the disease. Haematogenous spread to distant organs tends to occur later. The recommended treatment is surgical, governed by the site and extent of the lesion. Patients who do not have metastases at the time of presentation appear to have better prognosis, although the behaviour of the lesion may be unpredictable. The prognosis on the whole is not good, but may be improved by earlier diagnosis and adequate treatment.

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