Genitourinary Melanoma

Excerpt

Primary melanoma of the genitourinary (GU) tract is an extremely rare and clinically aggressive entity that comprises 0.2–1% of all melanoma cases, and includes tumors arising from the female GU tract, male GU tract, and urinary tract. Unlike cutaneous melanoma, etiological risk factors and epidemiological trends are not well established due to the rarity of GU melanoma. Little is known about the clinical course of GU melanoma subtypes, and the relative lack of documented cases has made it challenging to establish guidelines for clinical management of these neoplasms. Since a uniform staging system for these diseases has not yet been established, a number of different staging systems have been adopted and modified. Approaches to treatment are similarly heterogeneous, ranging from radical surgical excision to immunotherapies. Recent advancements in drug development and genetic analysis of tumors have led to promising new treatment modalities that warrant further investigation in clinical trials. Much of what is known about GU tract melanomas is documented in case studies and case series. It is possible that the establishment of centralized reporting databases could facilitate greater advancements in the understanding of GU tract melanomas and approaches to treatment. This chapter reviews the current literature on GU melanoma, highlighting key distinctions from cutaneous melanoma, with a focus on epidemiology, molecular and genetic alterations, diagnostic workup, clinical staging criteria, treatments, and future perspectives on the landscape of GU melanoma.