By Hilliard F. Seigler (auth.), H. F. Seigler (eds.)
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Finally, the most general starting assumption is that both mechanisms may work, and until there exists evidence that one is unlikely the safest assumption is the most general. All these arguments are of lesser importance, since they affect only how we conceptualize melanoma. The important and established fact about occult melanoma is that some of these patients who have melanoma in regional lymph nodes will achieve a long survival after lymph node resection. Figure 21. Amelanotic melanoma. 37 Amelanotic melanoma In the total collection of human tumors there are some that histologically resemble melanoma but do not contain sufficient melanin to be recognized even with special stains.
The true incidence, however, may be somewhat higher. In Wheelock and Clark's series of 59 793 surgical and 2822 autopsy specimens, there were 31 squamous cell carcinomas and two melanomas of the penis . While uncommon in humans, penile melanoma is relatively common in horses, again being limited primarily to white and gray horses . The usual presenting symptom of penile melanoma is a nodule or a lesion which has undergone recent change. Most lesions described are blue or blueblack and non tender.
Black lesion, ulcer blood-stained shorts mole lesion balanitis lesion Site glans glans glans ? glans glans & shaft glans glans glans glans glans glans glans glans glans glans glans ? glans glans & meatus meatus meatus ? prepuce glans glans prepuce glans & shaft glans glans glans glans glans glans ? glans glans ? glans glans, meatus prepuce glans glans glans Nodes + ? + + + + + + + + + ? + + ? ? + ? ? + ? ? + +* 44 Table 1 continued. Author Reference Patient age Baruah Shanik Tallerman 49 50 37 70 51 63 56 Kherzi 17 72 42 * Presenting symptoms Site glans ulcer glans, prepuce swollen, tender penis pain, swelling glans & corpora phimosis, difficulty voiding prepuce swelling, change in color glans prepuce lesion Nodes + + + ?