Primary Metastatic Melanoma of the Female Urethra Mimicking a Benign Urethral Caruncle : A Case Report.

Primary urethral melanoma is an exceptionally rare malignancy, comprising a small fraction of melanomas and malignant tumors affecting the female urethra. We report the case of a 74-year-old woman presenting with symptoms initially suggestive of a benign urethral caruncle, which was later diagnosed as nodular melanoma upon histopathological examination. Despite complete surgical excision, subsequent imaging revealed widespread metastases to lymph nodes, liver, lungs, and brain. The patient was promptly referred for systemic therapy. This case highlights the diagnostic challenges and emphasizes the importance of thorough staging and emerging treatment modalities, such as immunotherapy, in managing this aggressive malignancy.