Background: Primary malignant melanoma of the bladder (PMMB) represents an extraordinarily rare diagnostic entity among bladder malignancies, with fewer than 50 well-documented cases reported in modern medical literature. Due to its rarity, standardized treatment protocols remain undefined, and prognostic outcomes are poorly characterized. Case presentation: A 65-year-old man presented with a primary complaint of urinary tract irritation symptoms and an occupying lesion on the bladder wall detected during an enhanced CT scan. He underwent partial cystectomy and left ureterovesical reimplantation, and pathological results confirmed the diagnosis of PMMB. The prognosis was favorable, with no recurrence observed during a 24-month follow-up. Additionally, a comprehensive literature review was conducted to elucidate the typical characteristics and current therapeutic approaches reported to date, as evidence-based guidelines have yet to be established. Conclusion: Although PMMB is a rare bladder malignancy, certain similarities in its clinical and imaging features have been observed among the reported series. This study provides an additional summary of the tumor’s biological characteristics while discussing current treatment paradigms, future perspectives, and potential therapeutic strategies.

Background: Penile melanoma (PM) is an exceptionally rare and aggressive mucosal melanoma. Currently, it remains poorly understood, and no dedicated clinical guidelines have been established. This study aimed to characterize its clinical features and summarize its treatment options through our original case reports and a contemporary literature review. Case presentation: We present three cases of our medical center, all of whom underwent surgical treatment and were pathologically diagnosed with primary penile melanoma. The first case also underwent postoperative genetic testing and subsequent chemotherapy and achieved a marked reduction of lymph node metastasis. In terms of prognosis, two of them died of progression and one of other diseases. Our literature review subsequently analyzed 27 additional reported cases of PM, which mainly affects middle-aged and older men, with typical manifestations being pigmented patches or nodules on the glans or foreskin. Surgical treatment (local or partial penectomy) was the primary option. Adjuvant therapies, such as chemotherapy and radiotherapy, are commonly used to prevent recurrence, and emerging novel treatments are being evaluated in clinical trials, including immune checkpoint inhibitors and targeted therapies targeting genes such as KIT. Conclusion: Penile melanoma, as a rare but threatening malignancy, requires a personalized management strategy. A reasonable surgical plan should be made to ensure complete resection, with growing evidence supporting the integration of systemic therapies. Further case reports and clinical research are essential to establish standardized protocols.