This article describes the case of a 77-year old patient in whom a brownish bleeding glans lesion led to the diagnosis of a stage pT4b ulcerating melanoma of nodular subtype on excision biopsy, with a suspect lymph node in the left inguinal region. There was no evidence of nodal or distant metastatic disease. Punch biopsy confirmed nodal disease on the left side. Consequently, a complete glansectomy combined with an iliacofemoral lymphadenectomy was performed on the left side, as well as a sentinel procedure on the right side. Pathology showed residual melanoma in situ in the glans and one necrotic adenopathy (1/8) in the inguinal lymphadenectomy. For this node positive melanoma, the multidisciplinary team meeting agreed to start with nivolumab. Based on the ‘Melanoma Focus’ ano-uro-genital (AUG) mucosal melanoma guidelines, the current recommendations of practice are highlighted. However, the available evidence on AUG mucosal melanoma, and especially penile mucosal melanoma, is very limited.

(BELG J MED ONCOL 2020;14(2):74–9)