520 Malignant Melanoma: A Rare Primary Bladder Tumour

Abstract

Abstract A 60-year-old male patient who has been referred by his GP to our ‘one stop hematuria clinic’ due to episodes of visible hematuria for 3 months. The patient is Caucasian, non-smoker, drinking alcohol socially with no related family history of cancer. There is no occupational exposure to any carcinogens. Flexible cystoscopy that showed a dark coloured bladder mass arising from left side of the bladder base. CT urogram that showed evidence of soft tissue lesion in the urinary bladder with upstream mild left hydro-uretero-nephrosis. TURBT was performed carefully. Following complete resection of the tumour lesion, left ureteric orifice became visible. The morphology and immunohistochemistry profile were consistent with malignant melanoma. The presence of in situ component indicated a bladder primary origin rather than metastatic deposit. The case was discussed in our urology Multi-Disciplinary Team (MDT) meeting. Referral for dermatological consultation and radiological correlation were strongly advised in order to exclude any cutaneous or another mucosal primary malignant melanoma. The patient had no suspicious skin lesions. There was no evidence of soft tissue lesions on CT scans. In addition, further PET CT scan failed to show any other malignant lesions except for the bladder. After Histopathologic, dermatologic, and radiologic evidence; the diagnosis of primary urinary bladder malignant melanoma was established. Patient declined radical cystectomy and opted to go for immunotherapy. After completing a course of Nivolumab and Ipilimumab, patient is on a regular follow up cystoscopy with no evidence of recurrence.