前列腺恶性黑素瘤是罕见的。已报道了25项研究，描述了45例病例。前列腺黑素瘤以潜在起病和预后差异为特征。预后和治疗根据原发性或继发性黑素瘤的不同而异。一名75岁男子因为持续2个月的腰背痛就诊于医院。他否认有外伤史或异常尿液症状。直肠检查显示前列腺左叶有径向凹陷，直径为1厘米。他的前列腺特异性抗原为5.6ng/mL，18F-氟代脱氧葡萄糖正电子发射计算机断层扫描（18F-FDG-PET/CT）显示前列腺左叶有局部葡萄糖代谢。影像学显示骨转移至T12和双侧肋骨。采用经会阴穿刺前列腺活检，左侧出现三个组织标本显示前列腺腺癌（Gleason评分3 + 3 = 6），但右侧标本显示恶性黑素瘤。患者接受了T12瘤体切除，病理学结果显示转移性恶性黑素瘤。患者接受了胃镜检查和结肠镜检查，胃镜检查显示胃体和胃底有多个粘膜黑色斑点。患者被诊断为继发性恶性前列腺黑素瘤和原发性胃疾病。注意，诊断原发性前列腺黑素瘤需要谨慎，并且18F-FDG-PET/CT可能会导致黑素瘤的误阴性检测。© 作者2023年。白师灯出版集团有限公司所有，保留所有权利。

Malignant melanoma of the prostate is rare. Twenty-five studies describing 45 cases have been reported. Prostate melanoma is characterized by an insidious onset and poor prognosis. The prognosis and treatment vary according to primary or secondary melanoma.A 75-year-old man attended the hospital due to low back pain of 2 mo duration. He denied a history of trauma or abnormal urinary symptoms. Digital rectal examination showed indentation in the left lobe of the prostate, 1 cm in diameter. His prostate-specific antigen was 5.6 ng/mL and 18F-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) showed focal glucose metabolism in the left lobe. Imaging showed bone metastases to T12 and bilateral ribs. Transperineal prostate biopsy was done and three tissue specimens on the left side showed prostate adenocarcinoma (Gleason score 3 + 3 = 6), but the specimen on the right side showed malignant melanoma. The patient underwent T12 tumor resection and pathology findings indicated metastatic malignant melanoma. The patient underwent gastroscopy and colonoscopy, and gastroscopy revealed multiple mucosal black spots in the gastric body and fundus. The patient was diagnosed with secondary malignant prostate melanoma and primary gastric disease.Diagnosis of primary prostate melanoma requires caution and 18F-FDG-PET/CT may result in false-negative detection of melanoma.©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.