Melanoma of the glans penis successfully treated with topical imiquimod: dermoscopy usefulness in clinical monitoring and review of the literature

Scalvenzi, Massimiliano; Palmisano, Franco; Russo, Daniela; Mascolo, Massimo; Costa, Cláudia

doi:10.23736/s0392-0488.16.04789-1

Cited by 5 publications

(8 citation statements)

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“…[ 96 ] (2017) RA 12 12 67–96 μ = 79 MIS: cheek (4), jaw (1), nose (2), back (1), scalp (1), temple (1), preauricular (1), ear (1), H ± Pretreatment with topical 0.1% tazarotene cream (once/d for 2 weeks) Imiquimod 5% once/d 5 t/w (Monday-Friday) for 6–12 w NR Complete: 11 (H), 1 (C) 1.6–12.6 y 2 (H) Scalvenzi et al . [ 16 ] (2017) CR 1 1 38 MIS: penis H Imiquimod 5% once/d 3 t/w for 5 w, 4 w break, then imiquimod 5% once/d 2 t/w for 4 w NR Complete (H) 18 m 0 (C) Astorino et al . [ 97 ] (2018) CR 2 2 83–85 LM: nose, zygomatic H Imiquimod 5% 1 dose twice/d (12.5 mg in 250 mg cream during the morning and in occlusion during the evening 12 h/24) 5 t/w, at alternate w, for 5 w (3 of treatment and 2 of stop) NR Complete (C) 24–36 m 0 (C) Brand et al .…”

Section: Resultsmentioning

confidence: 99%

“…The latter was often not reported in the studies analyzed. Some young patients were also selected for imiquimod treatment, especially where difficulties were encountered with a surgical approach regarding body localization of the lesion, i.e., genital area [ 16 , 94 ].…”

Section: Resultsmentioning

confidence: 99%

“…The ranges of number of days/weeks of treatment and the total duration of the treatmetn regimen were extremely variable (1–7 days/weeks and 1–60 weeks, respectively) and depended on the body area and the tolerability of the patient, with differences among patients in the same study as well. Some authors reported the number of patients who did not complete the treatment [ 43 , 75 , 77 , 85 ] and/or who had a therapeutic break during the treatment protocol [ 16 , 17 , 50 , 56 , 68 , 86 , 93 ].…”

Section: Resultsmentioning

confidence: 99%

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Topical Treatment of Melanoma In Situ, Lentigo Maligna, and Lentigo Maligna Melanoma with Imiquimod Cream: A Systematic Review of the Literature

Vaienti,

Calzari,

Nazzaro

2023

Dermatol Ther (Heidelb)

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Introduction The classical management of melanoma is surgery, but this can be challenging because of several factors, such as age, body area, lesion size, among others. Topical imiquimod may be a therapeutic option for the treatment of melanoma in situ and lentigo maligna melanoma due to its efficacy, tolerability, and non-invasiveness. The purpose of this systematic review is to assemble current evidence on the treatment of non-metastatic melanoma with topical imiquimod. Methods The PubMed/MEDLINE and Cochrane Library databases were searched as the primary sources using the main search terms “imiquimod” combined with “lentigo maligna” and “melanoma” with the command “AND.” Articles were identified, screened, and extracted for relevant data, following the PRISMA guidelines. Results A total of 87 studies covering 1803 lesions treated with imiquimod cream were identified and included in this sytematic review. Forty-nine studies were case reports, 16 were retrospective analyses, 3 were open label trials, six were case series; one study was a controlled randomized trial, one was a randomized trial, and one was a single-arm phase III trial. Because of the high number of low-evidence studies, the overall risk of bias resulted high. In 55 studies, imiquimod 5% was used in monotherapy as the primary treatment; only in one study was imiquimod 3.75% introduced. In most cases, the topical treatment was applied once daily, with the exception of nine cases where an increased daily dosage was prescribed. The total duration of the treatment regimen was extremely variable and depended on body area and tolerability, with differences among patients of the same study. In six studies, imiquimod was used as neoadjuvant therapy before the surgical excision, and in 11 studies it was used after surgery as complementary or adjuvant therapy. In total, 1133 of the 1803 (62.8%) lesions were reported to be cleared after the treatment, taking into account that not all of the patients completed the treatment. Of these 1133 lesions, histological clearance was achieved in 645 (56.9%) lesions and clinical clearance only was achieved in 490 (43.2%) lesions; relapse occurred in 107 lesions. Conclusions The heterogeneity of the studies included in this systematic review precludes the drawing of any relevant conclusions regarding the application of imiquimod. Its efficacy in melanoma in situ and lentigo maligna melanoma has been demonstrated, but further evidence from controlled studies concerning the modalities is missing.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Topical Treatment of Melanoma In Situ, Lentigo Maligna, and Lentigo Maligna Melanoma with Imiquimod Cream: A Systematic Review of the Literature

Vaienti,

Calzari,

Nazzaro

2023

Dermatol Ther (Heidelb)

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“…33–35 In this context, dermoscopy and confocal microscopy have been proposed as useful tool in early diagnosis and during follow-up. 13…”

Section: Discussionmentioning

confidence: 99%

“…[33][34][35] In this context, dermoscopy and confocal microscopy have been proposed as useful tool in early diagnosis and during follow-up. 13 The clinical presentation of urethral melanomas includes hematuria, urethrorrhagia and other lower urinary tract symptoms and must be differentiated from the most common urothelial and prostate cancers. The development of this type of neoplasm in a not visible area could be one of the causes of the worse prognosis of urethral melanomas as compared to the glans melanomas.…”

Section: Clinical Presentationmentioning

confidence: 99%

Melanoma of glans penis and urethra: A case report and systematic review of the literature of a rare and complex neoplasm

et al. 2021

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Objective: To evaluate the features and prognosis of melanoma of glans penis and urethra, with the presentation of a significant case report. Materials and methods: A systematic literature review was performed using the MEDLINE (PubMed) and Cochrane Libraries databases to identify all cases of male mucosal melanoma reported. Results: Two hundred fifty-two patients with male mucosal primary melanoma were found. Glans penis and fossa navicularis as primary site includes the 81.6% of all lesions considered. Median Breslow’s depth is 2.1 mm, whereas nine in situ melanomas have been reported. At the diagnosis, the disease was at a non-localized stage in 21.4% for glans penis melanomas and 11.7% urethral lesions, respectively. The 2 and 5-year survival for glans melanoma is 62.5% and 38.4%; higher rates were observed in the 2012–2020 period (76% and 58.8%, respectively). Two-year survival for urethral melanomas is 66.7%, while 5-year survival is 12.5%. 22 patients survived over 5 years with a Breslow’s depth reported always < 3.3 mm. Conclusion: Melanoma of the glans penis and urethra is a rare neoplasm associated with a poor prognosis, however recent reports show higher survival rates. Surgery remains the mainstay for a localized disease. Taking into account the small number of cases reported, topical imiquimod seems to be a valid non-surgical alterative for melanoma in situ. The use of immunotherapy and targeted therapy should be considered only in an adjuvant setting according to the recommendations of cutaneous melanoma; however, additional clinical data on male mucosal melanoma are needed to draw definitive conclusions.

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Melanoma in situ of penis

et al. 2017

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Melanoma of the glans penis successfully treated with topical imiquimod: dermoscopy usefulness in clinical monitoring and review of the literature

Cited by 5 publications

References 0 publications

Topical Treatment of Melanoma In Situ, Lentigo Maligna, and Lentigo Maligna Melanoma with Imiquimod Cream: A Systematic Review of the Literature

Topical Treatment of Melanoma In Situ, Lentigo Maligna, and Lentigo Maligna Melanoma with Imiquimod Cream: A Systematic Review of the Literature

Melanoma of glans penis and urethra: A case report and systematic review of the literature of a rare and complex neoplasm

Melanoma in situ of penis

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