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Bladder
Other tumors
Melanoma of bladder
Author: Nat Pernick, M.D. (see Authors page)
Revised: 24 December 2009, last major update - December 2009
Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.
Definition
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● Primary tumors are rare (<50 cases reported) and are associated with melanosis; metastases are much more common
Terminology
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Epidemiology
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● Ages 44-81 years
● No gender preference
Sites
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Etiology
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Clinical features
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● Almost all reported cases are fatal
Prognostic factors
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Case reports
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● 80 year old woman with widespread melanosis in vagina and bladder developing into multifocal melanoma (Archives 1991;115:950)
● 82 year old man with no known non-bladder tumor (Int J Urol 2006;13:635)
● Melanoma with melanosis exhibiting atypia (Archives 1992;116:1213)
Treatment
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● Excision, possibly IL-2 (Urology 2003;62:351)
Clinical images
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Gross description (Macroscopy)
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● Occurs throughout bladder, variable pigmentation
Gross images
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Metastatic melanoma with numerous black focal metastases seen in bladder mucosa
Micro description (Histopathology)
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● Spindled or epithelioid; epithelioid cells often have marked pleomorphism, abundant cytoplasm, prominent eosinophilic nucleoli
● Necrosis and mitotic figures common
● Often atypical melanocytes
Micro images
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melanosis #1 (not melanoma); #2-Fontana Masson stain for melanin
metastatic tumor #1; #2-HMB45+
Cytology description
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Cytology images
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● Malignant cells, some with cytoplasmic melanin; also macrophages containing melanin (Acta Cytol 2001;45:631)
Positive stains
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● S100, HMB45, other melanocytic markers
Negative stains
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Electron microscopy descriptions
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Electron microscopy images
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Molecular / cytogenetics description
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Molecular / cytogenetics images
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Differential Diagnosis
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● Metastatic melanoma: clinical history of primary, although some primaries spontaneously regress so this may be difficult to conclusively establish; no bladder melanosis
Additional references
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End of Bladder > Other tumors > Melanoma of bladder
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