AbstractIntroduction Primary malignant melanoma of the urethra is an extremely rare disease associated with a poor prognosis due to early metastasis and often delayed diagnosis. There is limited literature on this entity, especially with regard to radiologic imaging. Presentation of case The case presented is a 67-year-old African American woman with primary urethral melanoma who underwent bladder-sparing surgery based upon pelvic magnetic resonance imaging (MRI) findings. Discussion {MRI} can be used for diagnosis of primary urethral melanoma and evaluation of tumor extent for surgical planning purposes. Conclusion Pelvic exenteration is often required for primary urethral melanoma treatment, though bladder conservation surgery may be a viable option in patients without evidence of bladder invasion on MRI.
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