Primary melanoma of the prostate: case report and review of the literature

Background: Primary melanoma of the prostate has an extremely rare incidence. Only five cases have been reported in the literature and prognosis is poor. The most likely origin of prostatic melanoma is the transitional epithelium of the prostatic urethra. Surgical care for primary melanoma of mucosal sites is less well established than for primary cutaneous melanoma, but excision of the primary is recommended if the patient has no systemic disease. Case presentation: Here, we describe a case of primary malignant melanoma of the prostate. A 37-year-old male patient with history of both chemo- and radiation therapy for Hodgkin’s disease was admitted to the University Hospital Heidelberg on suspicion of pleomorphic sarcoma of the bladder. In-house diagnostic work-up revealed a malignant melanoma of the prostate. We then performed radical prostatectomy with extended lymphadenectomy. Despite presumably curative surgery, the patient suffered from early relapse of disease with pulmonary metastasis. Systemic chemotherapy and subsequent immuno-oncologic treatment was thereafter initiated. Conclusion: Since prostatic melanoma is a rare disease and a melanoma metastasis of unknown primary is the differential diagnosis, a multidisciplinary approach including early imaging to rule out possible metastases and to search for another potentially existing primary is advisable. To prevent complications related to local tumor progression and to receive tissue for mutational analysis, we recommend complete surgical resection to reduce the tumor mass. Novel immune and targeted oncologic therapies can lead to an improved survival in some cases and support of clinical trials is needed

Intracardiac Extension of Wilms Tumor: A Case of a 2.5-Year-Old Girl Presenting with Upper Venous Congestion Caused by Tumor Growth into the Right Cardiac Ventricle

While Wilms tumors (WT) typically present solely with an abdominally palpable mass, rare cases exhibiting vascular tumor growth can also present with circulatory problems. Here, we report the case of a 2.5-year-old girl presenting with upper venous congestion and arterial hypertension as the primary symptoms of intraventricular tumor growth exhibiting remarkable tubular and perfused morphology. Clinical situation stabilized after initiation of neoadjuvant chemotherapy (NAC) with actinomycin D and vincristine, followed by surgical resection via laparotomy and sternotomy supported by cardiopulmonary bypass and deep hypothermia. Our results highlight the previously reported feasibility of this approach, even in primarily unstable patients

МODERN NON-INVASIVE METHODS FOR TREATING PEYRONIE'S DISEASE

Summary: Peyronie's disease (PD) is a common disease in men that can lead to significant penile deformity and pain, erectile dysfunction, and mental health problems. So far, surgical correction with plaque removal offers the greatest likelihood of success during the stable phase of the disease. However, for men in the acute phase of PD or those with a milder deformity who choose to avoid surgery, conservative treatment methods are also available. New innovative methods are extracorporeal shock wave therapy (ESWT) and ultrasound therapy. Intralesional therapy with IFN-α2b, verapamil, and Clostridium histolyticum (CCH) collagenase can significantly reduce penile deviation (PD), but these results may not be clinically significant in men with more severe disease. Iontophoresis (EMDA, electromotive drug administration) of verapamil and cortisone have shown reductions in PD and penile pain.Penile traction therapy offers clinically significant improvement in penile length and curvature. It requires daily therapy lasting several hours. Oral therapies with substances such as L-arginine, L-citrulline, vitamin E and phosphodiesterase inhibitors are most helpful as part of a combination regimen rather than as monotherapy. Regenerative therapies with stem cells and platelet-rich plasma, as well as intralesional therapy with botulinum toxin (Botox) have not yet been well clinically studied and their possible application is currently taking place within the framework of clinical research. The combination of various oral, topical, intralesional therapies, extracorporeal shock wave therapy, ultrasound and traction therapies together with clinical psychosexual therapy if needed could provide a more effective treatment, which in turn could prevent or reduce the need for definitive reconstructive penile surgery. Materials and methods: For the purposes of the literature review, a systematic search was conducted for articles in German and English on non-invasive treatment methods for Peyronie's disease. The articles were selected according to their relevance to the given topic. The main findings were summarized and presented in tabular form