Bladder metastasis from cutaneous melanoma during adjuvant immunotherapy: A case report and literature review
6 affiliations
- 1Department of Human Pathology ‘G. Barresi’, School of Specialization in Medical Oncology, University of Messina, I-98122 Messina, Italy
- 2Division of Oncology ‘Gaetano Martino’ Hospital, University of Messina, I-98122 Messina, Italy
- 3Anatomic Pathology Unit, ‘Gaetano Martino’ Hospital, University of Messina, I-98122 Messina, Italy
- 4Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, I-98122 Messina, Italy
- 5Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, I-98122 Messina, Italy
- 6Department of Medical Sciences, Section of Experimental Medicine, University of Ferrara, I-44121 Ferrara, Italy
Abstract
Cutaneous melanoma is among the most common malignancies in the United States and accounts for ~5% of all cancers. Melanoma preferentially metastasizes to lymph nodes, lungs, liver and brain, while bladder involvement is rare and associated with poor prognosis. The present study reports a 79-year-old woman with stage III, operable, BRAF wild-type melanoma of the back, treated with surgical excision and adjuvant immunotherapy. During adjuvant pembrolizumab treatment, a first solitary pulmonary relapse was observed. The metastasis was amenable to surgical resection, and the patient continued immunotherapy. Subsequently, recurrent haematuria led to the identification of a bladder lesion, which was removed via transurethral resection and the pathological evaluation confirmed metastatic melanoma. Following this second relapse, restaging imaging documented systemic disease progression involving lymph nodes, liver and bone. The patient then initiated first-line treatment with nivolumab and ipilimumab, achieving an ongoing clinical and radiological partial response. This study highlights several clinically relevant aspects: The potential role of local treatment strategies for oligoprogressive disease in prolonging the benefit of immunotherapy, the rare occurrence of bladder metastasis during adjuvant pembrolizumab, and the activity of combined cytotoxic T-lymphocyte-associated protein 4/programmed cell death protein 1 (PD-1) blockade even after progression on prior anti-PD-1 therapy. Early recognition of atypical metastatic sites and multidisciplinary management may contribute to prolonged disease control in selected patients with metastatic melanoma.
Related
- Development and internal validation of machine learning models for predicting lymph node metastasis in cutaneous head and neck melanoma
- Development and validation of machine learning-based models for identifying synchronous distant metastasis at initial diagnosis in cutaneous melanoma using the SEER database
- Machine learning based regulatory T cells related gene signature for predicting the clinical outcome and immunotherapy benefits in skin cutaneous melanoma
- Adjuvant immunotherapy in high-risk stage II melanoma: real-world outcomes from a large multicenter retrospective study
- Absence of Viable Tumor Cells in Macroscopically Pigmented Regional Lymph Nodes after Immune Checkpoint Inhibitor Therapy in Duodenal Metastasis of Cutaneous Melanoma: A Case Report.
BibTeX
@article{marafioti2026bladder,
title = {{Bladder metastasis from cutaneous melanoma during adjuvant immunotherapy: A case report and literature review}},
author = {Mariapia Marafioti and Martina Musarra and Ludovica Pepe and Riccardo Laudicella and Maria Ilenia Passalacqua and Mario Vaccaro and Giuliana Ciappina and Maria Lentini and Mariacarmela Santarpia},
journal = {Molecular and clinical oncology},
year = {2026},
month = oct,
doi = {10.3892/mco.2026.2982},
url = {https://europepmc.org/article/PMC/PMC13725748},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Bladder metastasis from cutaneous melanoma during adjuvant immunotherapy: A case report and literature review
AU - Mariapia Marafioti
AU - Martina Musarra
AU - Ludovica Pepe
AU - Riccardo Laudicella
AU - Maria Ilenia Passalacqua
AU - Mario Vaccaro
AU - Giuliana Ciappina
AU - Maria Lentini
AU - Mariacarmela Santarpia
PY - 2026
DA - 2026/10/20
JO - Molecular and clinical oncology
DO - 10.3892/mco.2026.2982
UR - https://europepmc.org/article/PMC/PMC13725748
AB - Cutaneous melanoma is among the most common malignancies in the United States and accounts for ~5% of all cancers. Melanoma preferentially metastasizes to lymph nodes, lungs, liver and brain, while bladder involvement is rare and associated with poor prognosis. The present study reports a 79-year-old woman with stage III, operable, BRAF wild-type melanoma of the back, treated with surgical excision and adjuvant immunotherapy. During adjuvant pembrolizumab treatment, a first solitary pulmonary relapse was observed. The metastasis was amenable to surgical resection, and the patient continued immunotherapy. Subsequently, recurrent haematuria led to the identification of a bladder lesion, which was removed via transurethral resection and the pathological evaluation confirmed metastatic melanoma. Following this second relapse, restaging imaging documented systemic disease progression involving lymph nodes, liver and bone. The patient then initiated first-line treatment with nivolumab and ipilimumab, achieving an ongoing clinical and radiological partial response. This study highlights several clinically relevant aspects: The potential role of local treatment strategies for oligoprogressive disease in prolonging the benefit of immunotherapy, the rare occurrence of bladder metastasis during adjuvant pembrolizumab, and the activity of combined cytotoxic T-lymphocyte-associated protein 4/programmed cell death protein 1 (PD-1) blockade even after progression on prior anti-PD-1 therapy. Early recognition of atypical metastatic sites and multidisciplinary management may contribute to prolonged disease control in selected patients with metastatic melanoma.
SN - 2049-9450
SN - 2049-9469
ER -