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Cao Q, Goldenberg M, Aron M, Wang T. Urinary Bladder "Melanosis": A Case Report and Review of the Literature. Int J Surg Pathol 2024; 32:104-108. [PMID: 37016968 DOI: 10.1177/10668969231166301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Melanosis of the urinary bladder, so-called melanosis vesicae, is a rare condition characterized by dark, velvety bladder mucosa observed by cystoscopy examination. Up to 20 examples have been reported in the English literature, and the etiology of this disease still needs to be discovered. We present an 82-year-old woman with a history of pelvic organ prolapse-associated urinary symptoms. The patient was found to have pigmented urinary bladder mucosa on cystoscopy and underwent a total hysterectomy and bladder mucosal biopsy. Histologically, pigmented granules were evident in the bladder stroma and epithelium, highlighted by Periodic Acid-Schiff (PAS) stain, suggestive of lipofuscin in nature. We outline the diagnostic features of bladder melanosis, discuss the diagnostic mimickers, and thoroughly review the literature on the subject.
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Affiliation(s)
- Qi Cao
- Department of Pathology and Laboratory Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mitchell Goldenberg
- Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Manju Aron
- Department of Pathology and Laboratory Medicine, University of Southern California, Los Angeles, CA, USA
| | - Tiannan Wang
- Department of Pathology and Laboratory Medicine, University of Southern California, Los Angeles, CA, USA
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Melanosis of the Bladder: Possible Pathogenetic Mechanisms. Case Rep Urol 2022; 2022:6221499. [PMID: 35754918 PMCID: PMC9225889 DOI: 10.1155/2022/6221499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/04/2022] [Indexed: 11/22/2022] Open
Abstract
Melanin accumulation within the bladder urothelium and/or macrophages in the lamina propria (melanosis of the bladder) is a very rare phenomenon of unknown pathogenesis. Its rarity argues for a complex, likely multifactorial, causation. We describe bladder melanosis developing after Botox therapy in an elderly woman with a history of overactive bladder, treated grade 2 uterovaginal prolapse, and episodes of urinary tract infection and speculate that one factor (probably of many) in its pathogenesis may be a derangement of local neurourothelial interactions.
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Abstract
Melanosis of the bladder is rare. Only 10 cases have been described in the literature. We present the case of an 80-year-old woman with neurogenic lower urinary tract dysfunction due to spinal paralysis. During the diagnostic work-up which included cystoscopy, black spots in the bladder wall were observed. Histopathological evaluation revealed a benign suburothelial melanosis. Thus, with cystoscopic suspicion of a malignancy (melanoma), a biopsy is mandatory and regular cystoscopic follow-up is recommended.
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Affiliation(s)
- J Wöllner
- Neuro-Urologie, Schweizer Paraplegiker Zentrum, Guido A. Zäch Straße 1, CH-6207, Nottwil, Schweiz.
| | - J Janzen
- Praxis für Histopathologie, Bern, Schweiz
| | - J Pannek
- Neuro-Urologie, Schweizer Paraplegiker Zentrum, Guido A. Zäch Straße 1, CH-6207, Nottwil, Schweiz
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Melanoma of the urinary bladder: a review of the literature. Surg Res Pract 2014; 2014:605802. [PMID: 25374957 PMCID: PMC4208590 DOI: 10.1155/2014/605802] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 10/30/2013] [Indexed: 11/17/2022] Open
Abstract
Background. Melanomas of the urinary bladder and urethra are rare. Aims. To review the literature on the disease. Methods. Various Internet databases were used to identify reported cases of the disease. Results. Less than 30 cases of primary melanoma of the urinary bladder and urethra have been reported in the literature and they have been associated with melanosis and commonly with metastases. The lesions may be primary or metastatic with no gender preference. The diagnostic features include pigmented raised lesions which histologically exhibit spindled or epitheliod cells, necrosis, mitotic figures, and atypical melanocytes. Immunohistochemically they stain positively with S100; HMB45; and other melanocyte markers, but negatively with Keratin and Vimentin. The treatment involves excision and possibly IL-2. The prognostic factors include size and depth of invasion as well as metastatic lesions. Conclusions. Less than 30 cases (about 24 cases) of the disease have been reported. There are also reports of metastatic melanomas of the urinary bladder emanating from primary melanomas originating elsewhere. Diagnosis of the primary disease is based upon the histological appearance of the lesion, positive staining with S100 and HMB45, and evidence of absence of melanoma elsewhere. Primary melanoma of the bladder is usually a fatal lesion.
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Manson-Bahr DA, Swamy R, Adshead JM. A case of benign vesica melanosis – four-year follow-up. JOURNAL OF CLINICAL UROLOGY 2013. [DOI: 10.1177/2051415813507053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Benign vesica melanosis (BVM) is a rare condition with only 15 reported cases in the literature (Table 1). There is limited understanding of its aetiology. Here we present a four-year follow-up of a case of BVM in a 53-year-old Caucasian male presenting with lower urinary tract symptoms.
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Affiliation(s)
| | - Rajiv Swamy
- Department of Histopathology, Hertfordshire and South Bedfordshire Urological Cancer Centre, UK
| | - Jim M Adshead
- Department of Urology, Hertfordshire and South Bedfordshire Urological Cancer Centre, UK
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Talmon GA, Khan AU, Koerber RK, Johansson SL. Simple melanosis of the bladder: a rare entity. Int J Surg Pathol 2010; 18:547-9. [PMID: 20444730 DOI: 10.1177/1066896909352863] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Simple melanosis of the bladder is an uncommon condition with fewer than 15 reported cases characterized by multifocal, diffuse melanin pigmentation of the urothelial mucosa. It is frequently associated with urinary incontinence or urgency. Histologically, melanin granules are present within urothelial cells or lamina propria macrophages with or without bland-appearing mucosal melanocytes. Although considered a benign entity, the rarity of the lesion warrants regular follow-up cystoscopic evaluation with biopsies to screen for the development of malignancy, especially malignant melanoma. This study presents a "typical" case with light, cytochemical, immunohistochemical, and ultrastructural characterization.
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Sen Gupta R, Seidl E, Oberpenning F. An unusual and rare case of urinary bladder melanosis. J Endourol 2010; 24:525-6. [PMID: 20218893 DOI: 10.1089/end.2009.0603] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Robin Sen Gupta
- Department of Pathology, St. Agnes Hospital Bocholt, Bocholt, Germany.
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Jin B, Zaidi SY, Hollowell M, Hollowell C, Saleh H. A unique case of urinary bladder simple melanosis: a case report and review of the literature. Diagn Pathol 2009; 4:24. [PMID: 19624817 PMCID: PMC2722577 DOI: 10.1186/1746-1596-4-24] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2009] [Accepted: 07/22/2009] [Indexed: 11/18/2022] Open
Abstract
Melanosis refers to abnormal or excessive deposition of melanin pigment in the cells and/or tissue, which can be seen in any organ but commonly in skin and oral mucosa. Melanosis of the urinary bladder is an extremely rare benign condition and only a handful of cases been reported in the English literature before. In this article, we report a new case of urinary melanosis, describe the differential diagnostic features from pseudomelanosis and offer clues for correct diagnosis. We also provide comprehensive review of the literature on the subject.
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Affiliation(s)
- Bo Jin
- Department of Pathology, Sinai-Grace Hospital/Detroit Medical Center, Wayne State University School of Medicine, 6071 West Outer Drive, Detroit, MI 48235 USA.
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Sanborn SL, MacLennan G, Cooney MM, Zhou M, Ponsky LE. High-grade transitional cell carcinoma and melanosis of urinary bladder: case report and review of the literature. Urology 2008; 73:928.e13-5. [PMID: 19056107 DOI: 10.1016/j.urology.2008.05.039] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2008] [Revised: 04/20/2008] [Accepted: 05/13/2008] [Indexed: 11/16/2022]
Abstract
Melanosis of the urinary bladder is a rare entity. It is generally regarded as a benign condition, but it is sometimes associated with primary malignant melanoma of the urinary bladder. It has never been reported to be connected with transitional cell carcinoma. We present a case of a woman with melanosis of the bladder who a year later developed high grade transitional cell bladder carcinoma.
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Affiliation(s)
- Sharon L Sanborn
- Department of Hematology and Oncology, University Hospitals Case Medical Center, Cleveland, Ohio 44106, USA
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Russo V, Borzacchiello G, Brun R, D'Ischia M, Napolitano A, Paciello O, Panzella L, Roperto F, Urraro C, Roperto S. Melanosis of the Urinary Bladder in a Cow. Vet Pathol 2008; 45:46-50. [DOI: 10.1354/vp.45-1-46] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Melanosis of the urinary bladder is a very rare condition characterized by an abnormal black or brownish-black pigmentation of the organ. The pigmentary disorder can involve both the urothelial cell layers and/or the submucosa. The biologic potential of the melanosis of urinary bladder remains unknown because only a few cases have been reported in medical literature. So far melanosis of the urinary bladder is not known to occur in cattle. Here we describe the first case of melanosis of the urinary bladder in an inbred red-spotted, 7-year-old cow. Light, ultrastructural, and immunohistochemic investigations demonstrated melanin pigment in the submucosa and lamina propria but not the urothelium of the bladder. In addition, biochemical characterization of the pigment-laden cells demonstrated that the pigment of this disorder consisted mainly of eumelanin, thus corroborating the morphologic studies. Finally, virologic examination revealed the presence of bovine papillomavirus type 2.
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Affiliation(s)
- V. Russo
- Department of Pathology and Animal Health, Faculty of Veterinary Medicine, Naples University Federico II, Naples, Italy
| | - G. Borzacchiello
- Department of Pathology and Animal Health, Faculty of Veterinary Medicine, Naples University Federico II, Naples, Italy
| | - R. Brun
- Department of Pathology and Animal Health, Faculty of Veterinary Medicine, Naples University Federico II, Naples, Italy
| | - M. D'Ischia
- Department of Organic Chemistry and Biochemistry, Naples University Federico II, Naples, Italy
| | - A. Napolitano
- Department of Organic Chemistry and Biochemistry, Naples University Federico II, Naples, Italy
| | - O. Paciello
- Department of Pathology and Animal Health, Faculty of Veterinary Medicine, Naples University Federico II, Naples, Italy
| | - L. Panzella
- Department of Organic Chemistry and Biochemistry, Naples University Federico II, Naples, Italy
| | - F. Roperto
- Department of Pathology and Animal Health, Faculty of Veterinary Medicine, Naples University Federico II, Naples, Italy
| | - C. Urraro
- Department of Pathology and Animal Health, Faculty of Veterinary Medicine, Naples University Federico II, Naples, Italy
| | - S. Roperto
- Department of Pathology and Animal Health, Faculty of Veterinary Medicine, Naples University Federico II, Naples, Italy
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