Assuntos
Antibióticos Antineoplásicos/uso terapêutico , Doxorrubicina/análogos & derivados , Infecções por HIV/complicações , Neoplasias Labiais/secundário , Neoplasias Bucais/secundário , Neoplasias Penianas/secundário , Sarcoma de Kaposi/tratamento farmacológico , Adulto , Doxorrubicina/uso terapêutico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/genética , Humanos , Masculino , Polietilenoglicóis/uso terapêuticoRESUMO
UNLABELLED: The surgical management of patients with symptomatic metastatic or locally advanced recurrences involving the penis remains poorly characterized. The aim of the present abstract and video is to detail our experience in the surgical management of a specific patient with a locally advanced symptomatic recurrence of penile sarcoma secondary to prostate cancer treated with primary brachytherapy. MATERIALS AND METHODS: A 70 year old male patient initially treated for localized prostate cancer with interstitial brachytherapy at an outside facility developed an unfortunate secondary malignancy consisting of a locally advanced penile sarcoma involving as well the prostate and base of the bladder. Despite our best efforts to control his pain, he developed a very symptomatic local recurrence with a secondary penile abscess and purulent periurethral drainage. At this time, it was felt a surgical resection consisting of a total penectomy, urethrectomy, cystoprostatectomy, and ileal conduit urinary diversion would be the best option for local cancer control in this particular patient. RESULTS: The patient underwent the surgical resection without any complications as illustrated in this surgical video, with a jejunal intestinal mass identified at the time of surgery which was resected with a primary bowel anastomosis performed. The patient was discharged from hospital uneventfully with his symptomatic local recurrence being successfully managed and the patient no longer requiring oral narcotics for pain control. The pathological report confirmed a locally advanced sarcoma involving the penile, prostate, and bladder which was resected with negative surgical margins and the jejunal mass was confirmed to represent a small bowel sarcoma metastatic site. CONCLUSION: As highlighted in the present video, the treatment of a symptomatic sarcoma local recurrence contiguously involving the penis can be successfully managed provided the patient is informed of the potential morbidity and psychosocial implications imparted by performing a total penectomy and adjacent organ resection.
Assuntos
Recidiva Local de Neoplasia/cirurgia , Segunda Neoplasia Primária/cirurgia , Neoplasias Penianas/cirurgia , Neoplasias da Próstata/radioterapia , Sarcoma/cirurgia , Idoso , Braquiterapia , Humanos , Masculino , Neoplasias Penianas/secundário , Sarcoma/secundário , Resultado do TratamentoRESUMO
Background The surgical management of patients with symptomatic metastatic or locally advanced recurrences involving the penis remains poorly characterized. The aim of the present abstract and video is to detail our experience in the surgical management of a specific patient with a locally advanced symptomatic recurrence of penile sarcoma secondary to prostate cancer treated with primary brachytherapy. Materials and Methods A 70 year old male patient initially treated for localized prostate cancer with interstitial brachytherapy at an outside facility developed an unfortunate secondary malignancy consisting of a locally advanced penile sarcoma involving as well the prostate and base of the bladder. Despite our best efforts to control his pain, he developed a very symptomatic local recurrence with a secondary penile abscess and purulent periurethral drainage. At this time, it was felt a surgical resection consisting of a total penectomy, urethrectomy, cystoprostatectomy, and ileal conduit urinary diversion would be the best option for local cancer control in this particular patient. Results The patient underwent the surgical resection without any complications as illustrated in this surgical video, with a jejunal intestinal mass identified at the time of surgery which was resected with a primary bowel anastomosis performed. The patient was discharged from hospital uneventfully with his symptomatic local recurrence being successfully managed and the patient no longer requiring oral narcotics for pain control. The pathological report confirmed a locally advanced sarcoma involving the penile, prostate, and bladder which was resected with negative surgical margins and the jejunal mass was confirmed to represent a small bowel sarcoma metastatic site. Conclusion As highlighted in the present video, the treatment of a symptomatic sarcoma local recurrence contiguously involving the penis can be successfully managed provided the patient ...
Assuntos
Idoso , Humanos , Masculino , Recidiva Local de Neoplasia/cirurgia , Segunda Neoplasia Primária/cirurgia , Neoplasias Penianas/cirurgia , Neoplasias da Próstata/radioterapia , Sarcoma/cirurgia , Braquiterapia , Neoplasias Penianas/secundário , Sarcoma/secundário , Resultado do TratamentoRESUMO
This study presents clinicopathologic and outcome features of 17 patients with metastatic tumor to the penis. Primary sites and histological types were as follows: 6 urothelial carcinomas of urinary bladder, 4 prostatic carcinomas (2 adenocarcinomas and 2 adenosquamous carcinomas), 2 colorectal adenocarcinomas, 2 pulmonary carcinomas (1 squamous cell carcinoma and 1 small cell carcinoma), 1 squamous cell carcinoma of base of the tongue, 1 cutaneous malignant melanoma, and 1 acute myeloid leukemia. Literature review revealed similar distribution of organ sites in 437 cases. Most of our tumors were metachronous. Interval between primary and penile metastasis ranged from 3 to 60 months (mean 16 months). Most of the patients presented with a penile mass. Priapism was observed in 4 patients. The shaft was the commonest anatomical site involved (12 cases). Tumor emboli were usually found in the erectile tissues (14 cases), mainly corpora cavernosa. A total of 14 patients died of disseminated disease. Time interval between primary tumor and penile metastasis ranged from 3 to 60 months (mean 19 months) and between diagnosis of penile metastasis and death ranged from 0.25 to 18 months (mean 6 months), significantly shorter (P = .0058). Patients presented a median survival of 18 months from primary treatment and 5 months after diagnosis of penile metastasis. None of the patients who died of disseminated cancer lived more than 18 months after pathological diagnosis. Clinical evidence of penile involvement in a patient with a known malignancy is an ominous sign and should alert the clinicians to the dismal prognosis.
Assuntos
Carcinoma/secundário , Melanoma/secundário , Neoplasias Penianas/secundário , Idoso , Carcinoma/mortalidade , Neoplasias Gastrointestinais/mortalidade , Neoplasias Gastrointestinais/patologia , Humanos , Estimativa de Kaplan-Meier , Leucemia Mieloide Aguda/mortalidade , Leucemia Mieloide Aguda/patologia , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Masculino , Melanoma/mortalidade , Pessoa de Meia-Idade , Neoplasias Penianas/mortalidade , Neoplasias da Língua/mortalidade , Neoplasias da Língua/patologia , Neoplasias Urogenitais/mortalidade , Neoplasias Urogenitais/patologiaRESUMO
Metastasis to the penis is an unusual event. Bladder and prostate tumors are the main sources of penile metastasis. Other sites include the rectosigmoid, kidney, and, less frequently, the pancreas, liver, nasopharynx, and lung. Other sources include malignant melanoma and Burkitt's lymphoma. The differential diagnosis includes idiopathic priapism, venereal or infectious disease, tuberculosis, Peyronie's disease, and primary penile tumor. Chondrosarcoma of the jaw is responsible for 10% of all chondrosarcomas that originate with craniofacial bones. Its behavior is usually characterized by local aggression; however, distant metastasis is uncommon. We report a case of chondrosarcoma of the jaw with penile metastasis. This is the first case described in published medical reports.
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Condrossarcoma/secundário , Neoplasias Mandibulares/patologia , Neoplasias Penianas/secundário , Adulto , Condrossarcoma/patologia , Condrossarcoma/cirurgia , Humanos , Masculino , Neoplasias Mandibulares/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Penianas/patologiaRESUMO
The majority of squamous cell carcinomas of the penis arise from the glans, and the prognosis is related significantly to the depth of invasion of crucial anatomic landmarks. Accurate information related to this can only be obtained when specimens are carefully evaluated grossly. Most pathologists in developed countries encounter resected specimens of penile carcinoma infrequently, and gross evaluation is occasionally suboptimal, potentially preventing obtaining reliable prognostic information. The four distinct levels of the glans penis are the epithelium, lamina propria, corpus spongiosum, and corpus cavernosum. A simple method for pathologic evaluation of the glans is presented. Noteworthy findings in our study of a South American population were that the distance from the lamina propria to tunica albuginea ranged from 7 to 13 to 6 mm at the dorsal, central, and ventral areas of the corpus spongiosum, respectively. The most distal portion of the corpus cavernosum was located within the glans in 34 of 44 cases and in the body of the penis in only 10. The corpus spongiosum was thinner in the former cases. These anatomic variations may bear on prognosis.
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Carcinoma de Células Escamosas/cirurgia , Neoplasias Penianas/cirurgia , Pênis/cirurgia , Adenocarcinoma/secundário , Adenocarcinoma/cirurgia , Carcinoma de Células Escamosas/patologia , Humanos , Masculino , Invasividade Neoplásica , Neoplasias Penianas/secundário , Pênis/patologia , Prognóstico , Neoplasias da Próstata/secundário , Neoplasias da Próstata/cirurgiaRESUMO
Among sexually transmitted diseases, infection by human papillomavirus (HPV) has become one of the most important. On the other hand, though epidemiological data show that some HPV types are closely associated with cervical cancer, few reports have been found with reference to penile carcinoma because of its rare occurrence. The aim of this study was to investigate the relationship between HPV infection and penile cancer in Argentina. A retrospective study was carried out on 38 white men with penile squamous-cell carcinoma. Sixty-five archival fixed biopsies taken from 34 primary penile tumors, 25 nodal metastases, 1 skin "satellite" metastasis and 5 histologically normal lymph nodes were used as specimens. HPV detection and typing were carried out by the polymerase chain reaction (PCR) using generic primers, combined with single-stranded conformational polymorphism (SSCP) analysis. HPV DNA was found in 71% patients, corresponding 81% of them to "high risk" types, with predominance of HPV 18. Both primary tumors and metastases showed concordance of HPV occurrence and type in both lesions. In 3 patients, HPV 16 was detected not only in primary tumors and metastases, but also in histologically normal lymph nodes. Our data indicate that most penile carcinomas in Argentine patients are etiologically related to HPV, especially to "high risk" genital types. The agreement in HPV detection between primary tumors and metastases suggests a potential viral role in tumor progression. HPV detection in otherwise histologically normal lymph nodes might be useful as early marker of a metastatic process.
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Carcinoma de Células Escamosas/virologia , Papillomaviridae , Neoplasias Penianas/virologia , Adulto , Idoso , Argentina/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/secundário , DNA Viral/análise , Humanos , Linfonodos/virologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Papillomaviridae/genética , Neoplasias Penianas/epidemiologia , Neoplasias Penianas/secundário , Reação em Cadeia da Polimerase , Polimorfismo Conformacional de Fita Simples , Estudos Retrospectivos , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/secundário , Neoplasias Cutâneas/virologiaRESUMO
Metastatic carcinoma of the penis is uncommon. The primary tumour is most commonly reported to be in the genitourinary or gastrointestinal tract. A case of metastatic carcinoma of the penis, secondary to a primary carcinoma of the prostate gland, is described.
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Adenocarcinoma/secundário , Neoplasias Penianas/secundário , Neoplasias da Próstata/patologia , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Idoso , Humanos , Masculino , Neoplasias Penianas/patologia , Neoplasias Penianas/cirurgiaRESUMO
Metastic carcinoma of the penis is uncommon. The primary tumour is most commonly reported to be in the genitourinary or gastrointestinal tract. A case of metastatic carcinoma of the penis, secondary to a primary carcinoma of the prostate gland, is described