Abstract
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.