A Case Report of Metastatic Melanoma to the Bladder

Abstract

Objective: The objective of this report is to present the case of metastatic melanoma to the bladder, a rare and underdiagnosed condition due to its often asymptomatic characteristic. Case presentation: The case was a 62-year-old female patient, with a history of melanoma at the level of the first toe, with surgical and pharmacological management. The reason for consultation was hematuria. Cystoscopy revealed a single solid, erythematous lesion with necrosis and easy bleeding, and transurethral resection (TUR) was indicated. The pathology found metastatic ulcerated melanoma. Second-line treatment (pembrolizumab) was started and presented progression to the upper limbs and relapse at the bladder level. The patient died a year later. Discussion: Melanoma metastases to the genitourinary tract are common, but isolated bladder metastases are rare. Treatment is usually TUR of the lesion, cystectomy, chemotherapy, and radiation therapy. TUR is curative for lesions restricted to the epithelium, although radical cystectomy is usually the therapy of choice in patients with a localized tumor. Pembrolizumab has been shown to increase survival. The prognosis depends on the size and depth of the invasion. Conclusion: Metastatic cancer to the bladder is rare and underdiagnosed, it may be present in patients with melanoma, nonspecific urinary irritative symptoms, and hematuria. It tends to have a poor prognosis, and requires surgical treatment associated with systemic management.