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Annals of Dermatology Nov 2023Extramammary Paget disease (EMPD) is a rare adenocarcinoma that usually occurs in areas of the body that are rich in apocrine sweat glands. Great depth of tumor invasion...
Extramammary Paget disease (EMPD) is a rare adenocarcinoma that usually occurs in areas of the body that are rich in apocrine sweat glands. Great depth of tumor invasion is a well-known risk factor for worse prognosis. Paget cells usually are limited to the epidermis, whereas invasive EMPD, which infiltrates the dermis, is relatively rare. It is even rarer for the tumor to spread beyond the dermis. Only 3.1% of patients with EMPD of the penis and scrotum have exhibited infiltration of the subcutaneous fat layer. We report a case of a 62-year-old male with EMPD that invaded the subcutaneous fat layer. He presented with a several-year history of a slowly expanding erythematous plaque with the hypopigmented area on the left penoscrotum. One month before presentation, the patient had undergone punch biopsy at another hospital and diagnosed with EMPD. He had no personal history of urogenital cancers. The patient was treated with Mohs micrographic surgery, and negative margins were achieved after four stages. The histopathologic findings revealed Paget cells scattered throughout the epidermis. At the hypopigmented area, Paget cells extended to the subcutaneous fat layer with lymphovascular invasion. There was no evidence of recurrence at seven months postoperatively. Herein, we describe a case of hypopigmented EMPD that infiltrated the subcutaneous layer, which rarely has been reported in Korea.
PubMed: 38061710
DOI: 10.5021/ad.21.055 -
BMC Urology Jun 2024Carcinoma in situ of the bladder is a high-grade cancer that originates in the superficial layer of the bladder. It has the potential to invade nearby organs, and it can...
BACKGROUND
Carcinoma in situ of the bladder is a high-grade cancer that originates in the superficial layer of the bladder. It has the potential to invade nearby organs, and it can spread through blood and lymphatic circulation to distant parts of the body.
CASE PRESENTATION
A 58-year-old non-smoker male presented with gross and microscopic hematuria. His family history included his father's recent bladder cancer. Initial investigations showed hematuria, inflammation, negative urine culture, digital rectal examination revealed an enlarged right lobe of the prostate, and an elevated Prostate-Specific Antigen level. Histopathological examination of samples taken from the bladder mucosa and the prostate confirmed urothelial carcinoma in situ in the bladder and prostate. Further evaluation revealed no other metastasis. The tumor was classified as T4aN0M0. The patient underwent radical cystoprostatectomy and histopathological examination showed that the tumor invading the muscularis propria of the bladder as well as the prostatic glands, but no malignancy was found in prostatic urethra and other areas. The patient was discharged three weeks post-operation and completed on adjuvant chemotherapy consisting of Gemcitabine, and Cisplatin to prevent of relapse. The patient is currently in a good healthy.
CONCLUSION
The occurrence of bladder cancer metastasizing to the prostate without involving the prostatic urethra is uncommon and requires precise diagnostic techniques for accurate tumor classification. Early management is advised to enhance the prognosis for the patient.
Topics: Humans; Male; Middle Aged; Urinary Bladder Neoplasms; Prostatic Neoplasms; Carcinoma in Situ; Urethra
PubMed: 38879527
DOI: 10.1186/s12894-024-01516-6 -
Orphanet Journal of Rare Diseases Jun 2024Extramammary Paget's disease (EMPD) is a rare cancer that occurs within the epithelium of the skin, arising predominantly in areas with high apocrine gland concentration...
BACKGROUND
Extramammary Paget's disease (EMPD) is a rare cancer that occurs within the epithelium of the skin, arising predominantly in areas with high apocrine gland concentration such as the vulva, scrotum, penis and perianal regions. Here, we aim to integrate clinicopathological data with genomic analysis of aggressive, rapidly-progressing de novo metastatic EMPD responding to HER2-directed treatment in combination with other agents, to attain a more comprehensive understanding of the disease landscape.
METHODS
Immunohistochemical staining on the scrotal wall tumor and bone marrow metastasis demonstrated HER2 overexpression. Whole genome sequencing of the tumor and matched blood was performed.
RESULTS
Notable copy number gains (logFC > 0.9) on chromosomes 7 and 8 were detected (n = 81), with 92.6% of these unique genes specifically located on chromosome 8. Prominent cancer-associated genes include ZNF703, HOOK3, DDHD2, LSM1, NSD3, ADAM9, BRF2, KAT6A and FGFR1. Interestingly, ERBB2 gene did not exhibit high copy number gain (logFC = 0.4) although 90% of tumor cells stained HER2-positive. Enrichment in pathways associated with transforming growth factor-beta (TGFβ) (FDR = 0.0376, Enrichment Ratio = 8.12) and fibroblast growth factor receptor (FGFR1) signaling (FDR = 0.0082, Enrichment Ratio = 2.3) was detected. Amplicon structure analysis revealed that this was a simple-linear amplification event.
CONCLUSION
Whole genome sequencing revealed the underlying copy number variation landscape in HER2-positive metastatic EMPD. The presence of alternative signalling pathways and genetic variants suggests potential interactions with HER2 signalling, which possibly contributed to the HER2 overexpression and observed response to HER2-directed therapy combined with other agents in a comprehensive treatment regimen.
Topics: Humans; Paget Disease, Extramammary; Whole Genome Sequencing; Male; Receptor, ErbB-2; Aged; DNA Copy Number Variations
PubMed: 38831459
DOI: 10.1186/s13023-024-03169-y -
Asian Journal of Surgery Mar 2024
Topics: Humans; Urethra; Adenocarcinoma; Abdomen
PubMed: 38102007
DOI: 10.1016/j.asjsur.2023.12.023 -
Asian Journal of Surgery Dec 2023
Topics: Female; Humans; Abdomen; Adenocarcinoma; Urethra; Aged
PubMed: 37537057
DOI: 10.1016/j.asjsur.2023.07.143 -
Cureus Apr 2024Hereby, we present a rare case of malignant transformation in a long-standing case of pseudoepitheliomatous keratotic and micaceous balanitis (PKMB), which typically...
Hereby, we present a rare case of malignant transformation in a long-standing case of pseudoepitheliomatous keratotic and micaceous balanitis (PKMB), which typically affects older men. PKMB presents as whitish or silvery keratotic plaques on the glans and can remain stable for years, leading to potential confusion regarding its progression. The patient in this case experienced urinary obstruction due to tumorous ingrowth, prompting an investigation. Despite previous treatments, including fluorouracil (5-FU) and cryoablation, the lesion persisted, eventually growing in size and becoming malodorous. Initial biopsy showed PKMB without malignancy, but subsequent deeper biopsy revealed verrucous carcinoma. The patient underwent glansectomy and reconstruction with a full-thickness skin graft, achieving a disease-free state postoperatively. The paper underscores the importance of thorough investigation for malignancy in PKMB cases, the possibility of deeper malignancy missed by superficial biopsy, and the need for early diagnosis to enable organ-sparing treatments.
PubMed: 38774183
DOI: 10.7759/cureus.58671 -
Cureus Nov 2023Penile cancer is a rare genitourinary malignancy for which limited treatment options exist beyond primary surgical resection. Metastatic lymphadenopathy represents a...
Penile cancer is a rare genitourinary malignancy for which limited treatment options exist beyond primary surgical resection. Metastatic lymphadenopathy represents a particularly poor prognosis with a lack of literature to suggest the effectiveness of radiation or systemic therapies. Our case documents an inguinal recurrence of penile squamous cell carcinoma not amenable to surgical intervention demonstrating complete response to salvage radiotherapy in the palliative setting. These observations propose the need for further research around the utility of radiotherapy in the management of metastatic penile malignancies.
PubMed: 38106763
DOI: 10.7759/cureus.48815 -
Asian Journal of Surgery Apr 2024
Review
Topics: Humans; Female; Urethra; Adenocarcinoma, Clear Cell; Abdomen
PubMed: 38220522
DOI: 10.1016/j.asjsur.2023.12.205 -
Investigative and Clinical Urology May 2024To investigate the relationship between urine cytology results after overnight continuous saline irrigation (OCSI) following transurethral resection of bladder tumor...
Correlation between urine cytology results on the day after overnight continuous saline irrigation following transurethral resection of bladder tumor and bladder tumor recurrence.
PURPOSE
To investigate the relationship between urine cytology results after overnight continuous saline irrigation (OCSI) following transurethral resection of bladder tumor (TURBT) and bladder tumor recurrence in non-muscle invasive bladder cancer (NMIBC).
MATERIALS AND METHODS
A retrospective study was conducted on patients diagnosed with NMIBC between 2016 and 2020 after undergoing TURBT at our hospital. All patients received OCSI following TURBT and had urine cytology test at postoperative 1 day. Urine cytology was classified into three groups: Negative, low-grade urothelial neoplasm (LGUN)+atypical urothelial cells (AUC), and suspicious for high-grade urothelial carcinoma (SHGUC)+high-grade urothelial carcinoma (HGUC). Recurrence-free survival (RFS) in each group was compared using the Kaplan-Meier method. Univariable and multivariable Cox regression analyses were performed to evaluate independent prognostic factors.
RESULTS
A total of 172 patients were included in this study. Based on urine cytology group (after OCSI), RFS did not reach the median value in the Negative group. In the LGUN+AUC group, the median RFS was 615.00 days. In the SHGUC+HGUC group, the median RFS was 377.00 days. In survival analysis, the Negative group had a longer RFS than the SHGUC+HGUC group (p=0.013). However, Cox regression analysis showed that SHGUC+HGUC was not an independent prognostic factor for recurrence.
CONCLUSIONS
Urine cytology results after OCSI following TURBT in NMIBC were associated with bladder tumor recurrence. Specifically, SHGUC or HGUC in urine cytology after OCSI showed earlier recurrence than negative cases. However, further research is needed to accurately determine whether it is an independent prognostic factor.
Topics: Humans; Urinary Bladder Neoplasms; Neoplasm Recurrence, Local; Retrospective Studies; Male; Therapeutic Irrigation; Female; Aged; Middle Aged; Urine; Saline Solution; Cystectomy; Time Factors; Urethra; Urinalysis; Transurethral Resection of Bladder; Cytology
PubMed: 38714518
DOI: 10.4111/icu.20230284 -
BMC Urology Apr 2024Fasciitis ossificans is a rare subtype of nodular fasciitis, a benign soft tissue tumor with reactive characteristics. Due to its rapid growth, it is often misdiagnosed...
BACKGROUND
Fasciitis ossificans is a rare subtype of nodular fasciitis, a benign soft tissue tumor with reactive characteristics. Due to its rapid growth, it is often misdiagnosed as a malignant tumor. While fasciitis ossificans commonly originates from the subcutaneous tissue and can appear throughout the body, it may also arise from extraordinary sites.
CASE PRESENTATION
We report the first-ever documented case of fasciitis ossificans arising from the penis in a male patient who presented with a tumor on the glans penis. The tumor was surgically resected due to suspicion of penile cancer. Initial histopathological analysis led to a misdiagnosis of squamous cell carcinoma. However, pathological consultation ultimately confirmed the diagnosis of fasciitis ossificans of the penis originating from the glans penis by demonstrating ossification.
CONCLUSION
This case underscores the importance of considering fasciitis ossificans in the differential diagnosis of soft tissue tumors, even in unusual locations such as penile soft tissue.
Topics: Humans; Male; Ossification, Heterotopic; Pelvis; Diagnosis, Differential; Fasciitis; Penis; Penile Neoplasms
PubMed: 38594664
DOI: 10.1186/s12894-024-01475-y