# Melanoma of the urethra

Source: https://onco.cc/cancers/urethral-melanoma/  
OnCo record `urethral-melanoma` (Cancer). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Melanoma of the urethra is a very rare urethral cancer that starts in pigment cells of the urethral lining, usually near its outer opening, in older adults. It is a form of mucosal melanoma, so it is removed surgically and, when it spreads, treated with the immunotherapy drugs used for melanoma elsewhere.

## Summary

Primary melanoma of the urethra is a mucosal melanoma. In the series of 15 cases, the tumour involved the distal urethra in all six men and the distal urethra or meatus in eight of nine women; tumours were typically polypoid, 0.8 to 6 cm (mean 2.6 cm), every one had a vertical growth phase and the depth of invasion ranged from 2 to 17 mm (Oliva 2000). Among 11 women treated surgically at the Mayo Clinic over five decades (mean age 68), the study examined which tumour features predicted recurrence and disease-specific survival (DiMarco 2004). Men present with penile or urethral involvement and the outlook has classically been poor (Sanchez-Ortiz 2005).

How it differs from its parent: it is not a carcinoma at all, so none of the parent's bladder-cancer or anal-cancer analogies apply; staging and systemic therapy come from the mucosal melanoma page instead, and the WHO skin and genitourinary classifications treat mucosal melanoma as one entity across sites.

How common: no incidence figure is published; the case series above are the published evidence.

Treatment: complete excision (partial urethrectomy or, for proximal or bulky tumours, radical surgery) as reported in the surgical series (DiMarco 2004; Sanchez-Ortiz 2005), then the mucosal melanoma page's pathway for recurrent or metastatic disease, which rests on checkpoint inhibitors (nivolumab, pembrolizumab) and KIT testing; there is no trial in urethral melanoma itself.

## Fields

- Kind: Cancer
- Last checked: 2026-09-24
- Also known as: Urethral melanoma; Primary malignant melanoma of the urethra; Urethral melanoma (very rare); Genitourinary mucosal melanoma
- Tags: subtype-page; wave4; rare
- Group: genitourinary
- Burden: Very rare: the largest pathology series holds 15 cases, nine women and six men, aged 44 to 96 (mean 73) (Oliva 2000); a 40-year single-institution series found ten patients with penile or urethral melanoma (Sanchez-Ortiz 2005). No registry figure exists.
- Subtypes: Melanoma of the distal urethra and meatus (the usual site); Melanoma of the proximal urethra (rare)
- Biomarkers: Depth of invasion and vertical growth phase; KIT, NRAS and BRAF mutation testing as in mucosal melanoma; Node status

## Sections of this record

The page is a hub with ten sections in reading order; large sections have their own page. The same plan as JSON: https://onco.cc/api/v1/cancers/urethral-melanoma/sections.json

- Overview (on the hub): The TL;DR, the family this cancer belongs to, the organ, who gets it and what the state of the art is. https://onco.cc/cancers/urethral-melanoma/#overview
- What it is (on the hub): Anatomy, the subtypes and how they differ, how it is staged, and where advanced disease spreads. https://onco.cc/cancers/urethral-melanoma/#what-it-is [2 subtypes]
- Finding it (on the hub): How it shows itself, how it is confirmed, what screening exists, and the biomarkers clinicians test for. https://onco.cc/cancers/urethral-melanoma/#finding-it [3 biomarkers]
- Treating it (on the hub): The standard of care by setting, the medicines, surgery and radiotherapy named in it, and the regimens behind them. https://onco.cc/cancers/urethral-melanoma/#treating-it [1 setting, 1 decision with options]
- Evidence (on the hub): Trials recruiting now, the landmark trials, the key papers and what they mean, the latest literature, and the milestones year by year. https://onco.cc/cancers/urethral-melanoma/#evidence
- The science (on the hub): The molecular landscape: the targets and how often each appears, the pathways, the mechanics stages and the preclinical models. https://onco.cc/cancers/urethral-melanoma/#science [1 target]
- Where you are (own page): Cases by country, the UK and NHS pathway and other country lenses, and the expert centres with trials on record. https://onco.cc/cancers/urethral-melanoma/where-you-are/
- Living with it (on the hub): The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask. https://onco.cc/cancers/urethral-melanoma/#living-with-it [8 questions, 3 red cards]
- What is coming (own page): Everything in development, the open problems and what is being done about them, the roadmaps, and what changed on this record. https://onco.cc/cancers/urethral-melanoma/coming/ [2 medicines]
- Data (own page): Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked. https://onco.cc/cancers/urethral-melanoma/data/ [6 connected records]

## Standard of care

- All stages: Excision as reported in the surgical series; recurrent or metastatic disease treated as mucosal melanoma with checkpoint inhibitors. ([Mucosal melanoma](https://onco.cc/cancers/mucosal-melanoma/), [Nivolumab](https://onco.cc/drugs/nivolumab/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/))

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Mucosal_melanoma
- NCI PDQ: urethral cancer treatment: https://www.cancer.gov/types/urethral/patient/urethral-treatment-pdq
- Oliva 2000, Am J Surg Pathol: primary malignant melanoma of the urethra, 15 cases: https://doi.org/10.1097/00000478-200006000-00003
- DiMarco 2004, J Urol: surgical treatment of primary melanoma of the female urethra: https://doi.org/10.1097/01.ju.0000104671.20863.47
- Sanchez-Ortiz 2005, J Urol: melanoma of the penis, scrotum and male urethra: https://doi.org/10.1097/01.ju.0000159207.91737.53

## Connected records

- cancers: [Melanoma](https://onco.cc/cancers/melanoma/), [Mucosal melanoma](https://onco.cc/cancers/mucosal-melanoma/), [Squamous cell carcinoma of the urethra](https://onco.cc/cancers/urethral-squamous-cell-carcinoma/), [Urethral cancer](https://onco.cc/cancers/urethral/), [Urothelial carcinoma of the urethra](https://onco.cc/cancers/urethral-urothelial-carcinoma/), [Vulvar melanoma](https://onco.cc/cancers/vulvar-melanoma/)
- drugs: [Nivolumab](https://onco.cc/drugs/nivolumab/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/)

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JSON: https://onco.cc/api/v1/entities/urethral-melanoma.json