Malignant melanoma of the prostate gland: A systematic review

Aims: Prostatic melanoma is a rare malignancy about which only scattered case reports and no systematic reviews have been published to date. We sought to better inform clinicians and pathologists caring for these patients by gathering all available evidence on the topic. Methods: We performed a systematic review of English and non-English articles indexed in PubMed, EMBASE, Scopus and Google Scholar about primary and metastatic prostatic melanoma. Results: In total, 25 studies describing 45 cases were identified. Most cases were metastases to the prostate, with only 10 primary prostatic cases. The median age of patients was 61 years with a wide range, and 89% were symptomatic at presentation, most commonly with obstructive symptoms (83%). Diagnosis requires histopathological analysis and often immunohistochemistry. Metastatic melanoma in the prostate carries a dismal prognosis with median overall survival of 3 months; on the other hand, among primary prostatic melanomas reported in the literature, 29% survived longer than 5 years. The most reasonable therapeutic approach consists in radical surgery possibly followed by adjuvant therapy.