Medical decision making for melanoma of the glans penis

This case report describes a rare presentation of penile melanoma in which 3 successive primaries arose and were operated from an area of melanosis on the glans penis and prepuce. One of the major factors accounting for the poor prognosis of this patient was the long delay in presentation. This was largely due to the patient's r eluctance because of the site of the disease. When diffuse melanotic areas are present in the genital region, in particul ar given the reluctance of patients with skin lesions in this region to pre sent, the index of suspicion should be high with respect to the risk of tra nsformation and an aggressive follow -up policy should be advocated. Treatm ent guidelines should not significantly differ from the usual approach of c utaneous melanoma.