Metastatic Melanoma of the Urinary Bladder in the Era of Targeted Therapy
Published on: 2016-03-21
Metastasis of malignant melanoma to the urinary bladder is a rare clinical entity. Here we present the case of a 78 year-old man with metastatic melanoma in his bladder found on surveillance cystoscopy for previous bladder urothelial carcinoma, in the context of concurrent BRAF and MEK inhibitor therapy for melanoma metastasis to other sites. The bladder lesions were histologically confirmed to be melanoma, but despite lower urinary tract symptoms he was managed expectantly and succumbed to his disease some months later. This is only the second case in the English literature reporting bladder metastases from malignant melanoma with concurrent treatment of targeted therapy. There has been recent promise of longer survival amongst patients with metastatic melanoma afforded by these new therapies, and accordingly we may see a rise in incidence of stable metastases to rarer sites of spread and a need for improved local control of metastatic sites. Although we did not treat our patient’s bladder metastasis more aggressively due to his guarded prognosis, this case highlights the potential for metastasis to rarer sites in the context of increased survival from new therapies and the lack of relevant targeted intravesical treatments for bladder metastases.