Malignant melanoma of the penis.

The authors report the case of a very large, obstructive malignant melanoma (MM.) of the prepuce, encasing all of the distal extremity of the penis, a nd discovered at a late metastatic stage (regional lymph node metastasis). Palliative treatment, consisting of partial penectomy associated with a com plementary induction and maintenance chemotherapy did not achieve any objec tive response at one year. MM. of the penis are rare urological tumours, in cluding MM of the penis and MM of the male urethra (exclusively mucosal inv olvement). The diagnosis of MM of the penis must be considered in any case of black or brown lesion of the glans, which is the most frequent site. The prognosis is determined by the clinical stage (BRACKEN and DIOKNO classifi cation) and by the depth and level of tumour invasion (BRESLOW index and CL ARK's degree of dermal invasion). The 5-year survival is inversely proporti onal to the tumour thickness. The treatment of MM of the penis is surgical; the extent of resection and the indication for lymph node dissection depen d on the patient's age, sexuality, and the stage of the disease and depth o f tumour invasion.