Conservative Treatment of Penile Melanoma: Case Report and Literature Review

Abstract

Melanomas of the penis are highly aggressive malignant tumors. We report on a patient with a lesion confined to the prepuce and with clinically negative inguinal lymph nodes, treated conservatively. The patient underwent wide local excision (WLE) for treatment and histological diagnosis. Treatment of the inguinal region in patients with penile melanoma remains controversial, since the incidence of metastatic disease in those with early pathologicalstage disease is significantly lower. Since our patient presented penile melanoma pathological stage T2a (depth 1.9 mm, without ulceration), we chose to use pre-operative lymphoscintigraphy, intra-operative lymph node mapping, and sentinel node biopsy to evaluate inguinal metastatic involvement. Frozen sections in an excised right sentinel node were negative, and no adjuvant treatment was performed. WLE provided effective local control of the penile tumor, and the patient remains under postoperative surveillance.