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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.
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.
No registry figure exists.
Averages across everyone diagnosed, often years ago. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.
Renal cell carcinoma comes from the kidney's filtering cortex, urothelial cancer from the lining of the collecting system and bladder, and the adrenal on top hosts cortical and medullary (neuroblastoma) tumours.
Same organ: Collecting duct carcinoma of the kidney, Renal medullary carcinoma (SMARCB1-deficient), TFE3-rearranged (translocation) renal cell carcinoma, Fumarate hydratase-deficient renal cell carcinoma (HLRCC-associated), Succinate dehydrogenase-deficient renal cell carcinoma, Mucinous tubular and spindle cell carcinoma of the kidney, Eosinophilic solid and cystic renal cell carcinoma, Clear cell papillary renal cell tumour, Urothelial carcinoma of the urethra, Squamous cell carcinoma of the urethra, Adenocarcinoma of the urethra (including clear cell adenocarcinoma), Non-muscle-invasive bladder cancer, Muscle-invasive and advanced bladder cancer, Bladder & urothelial cancer, Clear cell renal cell carcinoma, Papillary renal cell carcinoma, Chromophobe renal cell carcinoma, Renal cell carcinoma, Wilms tumour (nephroblastoma), Neuroblastoma (paediatric), Low-risk neuroblastoma (INRG very low and low risk, including stage MS), Intermediate-risk neuroblastoma, High-risk neuroblastoma, Adrenocortical carcinoma, Pheochromocytoma and paraganglioma (PPGL), Urethral cancer, Penile cancer, Localised penile cancer (organ-confined, node-negative), Node-positive and metastatic penile cancer, Localised adrenocortical carcinoma (ENSAT stage I to III, resectable), Advanced and metastatic adrenocortical carcinoma (ENSAT stage IV or unresectable), Hereditary pheochromocytoma and paraganglioma (SDHx, VHL, RET, NF1, MAX and TMEM127), Metastatic pheochromocytoma and paraganglioma
Excision as reported in the surgical series; recurrent or metastatic disease treated as mucosal melanoma with checkpoint inhibitors.
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Query for this cancer: (TITLE:"Melanoma of the urethra" OR ABSTRACT:"Melanoma of the urethra" OR TITLE:"Urethral melanoma" OR ABSTRACT:"Urethral melanoma" OR TITLE:"Primary malignant melanoma of the urethra" OR ABSTRACT:"Primary malignant melanoma of the urethra" OR TITLE:"Urethral melanoma very rare" OR ABSTRACT:"Urethral melanoma very rare" OR TITLE:"Genitourinary mucosal melanoma" OR ABSTRACT:"Genitourinary mucosal melanoma") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Melanoma of the urethra, not a curated reading list.
The targets of this cancer's medicines and the ones linked to it directly.
Cases by country, the UK and NHS pathway and other country lenses, and the expert centres with trials on record.
One section per setting: the options named, what each is for, the trials behind them, the recorded trade-offs and the questions to ask.
Persistent headache with extreme tiredness, nausea, dizziness on standing or low blood pressure. Vomiting, severe weakness or collapse is adrenal crisis.
No pharmacokinetic interactions expected (antibody). See the irAE guide for toxicity management.
Immunotherapy can attack hormone-producing glands: most often the thyroid (usually ending in an under-active thyroid needing lifelong tablets), and less often the pituitary (hypophysitis) or adrenal glands, which can be life-threatening if missed.
See all on the product pages:NivolumabPembrolizumab·Printable cards in the navigator
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