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The Pan African Medical Journal 2020Buschke-Lowenstein (BLT) tumor or giant condyloma acuminatum (GCA) is a rare viral disease belonging to the group of verrucous carcinomas; the virus responsible is human...
Buschke-Lowenstein (BLT) tumor or giant condyloma acuminatum (GCA) is a rare viral disease belonging to the group of verrucous carcinomas; the virus responsible is human papilloma virus (HPV) type 6 and 11 which is transmitted in humans by sexual contact. It is characterized by its extension within the surface layer and at depth, by its degenerative potential and by its recurrent nature after treatment. Therapy is based on surgery. We report the case of a 53-year old patient with a history of recurrent urethritis and a multiplicity of partners without homosexual encounters, presenting with a lesion at the level of the penis. The symptoms started three years before and were caused by a nonpainful budding tumor growing gradually at the level of the root of the penis resulting in tingling and bleeding. Clinical examination showed a dyschromic, infiltrating, cauliflower-like, papillomatous tumor measuring 13cm along its longer axis on the dorsal surface of the penis, with patchy ulcers and extending to the suprapubic region. The remainder of the clinical examination was normal and the assessment of sexually transmitted infection (STI) was negative. Treatment was based on complete surgical resection of the tumor. Soft tissue was covered by the surrounding skin. The anatomopathological study showed a giant genital wart without signs of malignancy. The postoperative course was uneventful. The patient didn't develop tumor recurrence during a 5-year follow-up period.
PubMed: 33062121
DOI: 10.11604/pamj.2020.37.19.21024 -
European Urology Oncology Oct 2021
Topics: Carcinoma, Squamous Cell; Humans; Male; Papillomavirus Infections; Penile Neoplasms; Penis
PubMed: 33358392
DOI: 10.1016/j.euo.2020.12.005 -
Pathology, Research and Practice Jan 2023Extramammary Paget disease is an uncommon slow growing intraepithelial malignant neoplasm. It can be classified into primary and secondary subtypes, with secondary...
Extramammary Paget disease is an uncommon slow growing intraepithelial malignant neoplasm. It can be classified into primary and secondary subtypes, with secondary subtype associated with underlying malignancy. Extramammary Paget disease of the penoscrotal region is extremely rare with very limited literature available describing its clinicopathologic characteristics. We present 6 cases of penoscrotal EMPD diagnosed at our academic medical center over a 20 year period. These included 5 cases of scrotal EMPD and 1 case of penile EMPD. The mean age at diagnosis was 68.6 yrs. (Range 61-78 years), One case of scrotal EMPD had history of renal cell carcinoma and prostatic adenocarcinoma, while one other case presented as recurrent EMPD with initial disease in the left groin. EMPD in the glans penis was associated with a history of urothelial carcinoma in the ureter with pagetoid spread. 3 cases had no progression of the disease till recent follow up, 2 were lost to follow up while 1 case rapidly deteriorated resulting in death. This case had bone metastatic and associated peritoneal carcinomatosis. Thus, Extramammary Paget disease of the penoscrotal area is extremely rare, can be primary or associated with visceral malignancies and usually tends to present at an older age. Peritoneal spread and distant metastasis are associated with rapid progression of the disease.
Topics: Male; Humans; Aged; Paget Disease, Extramammary; Carcinoma, Transitional Cell; Urinary Bladder Neoplasms; Prostatic Neoplasms
PubMed: 36584497
DOI: 10.1016/j.prp.2022.154283 -
The Surgeon : Journal of the Royal... Jun 2022Penile cancer is a rare malignancy, with a reported incidence of 1.5/100,000 males in the Republic of Ireland in 2015. The aim of this study was to perform the first... (Review)
Review
OBJECTIVE
Penile cancer is a rare malignancy, with a reported incidence of 1.5/100,000 males in the Republic of Ireland in 2015. The aim of this study was to perform the first national review and to evaluate clinicopathological factors affecting survival.
SUBJECTS AND METHODS
All cases of penile cancer in Ireland between 1995 and 2010 were identified through the National Cancer Registry Ireland (NCRI) and analysed to identify factors affecting survival.
RESULTS
360 cases of penile cancer were identified, with a mean age at diagnosis of 65.5 years and 88% (n = 315) of cases occurred in those over 50. 91% (n = 328) of cases were squamous cell carcinomas (SCC). The majority of patients were treated surgically (n = 289), with 57% (n = 206) and 24% (n = 87) undergoing partial penectomy and total penectomy respectively. Only 18% (n = 65) received radiotherapy, and 8% (n = 27) received chemotherapy. Mean overall survival (OS) was 113 months, and five year disease specific survival (DSS) was 70% (95%CI: 59.1-77.8%). Age at diagnosis, nodal status and presence of metastatic disease were independent prognostic markers on multivariate analysis.
CONCLUSION
This study represents the first national review of penile cancer in Ireland. The annual incidence and survival rates are comparable to European figures, though superior DSS has previously been reported from our institution, highlighting the role for centralisation of care in Ireland.
LEVEL OF EVIDENCE
2b.
Topics: Carcinoma, Squamous Cell; Humans; Ireland; Male; Penile Neoplasms; Penis; Survival Rate
PubMed: 34034967
DOI: 10.1016/j.surge.2021.04.004 -
Radiographics : a Review Publication of... Aug 2023Penile malignancy is the third most common male-specific genitourinary malignancy, with squamous cell carcinoma representing the most common histologic type. Squamous...
Penile malignancy is the third most common male-specific genitourinary malignancy, with squamous cell carcinoma representing the most common histologic type. Squamous cell carcinoma is an epithelial malignancy, frequently developing from the mucosal surfaces of the foreskin, glans, and coronal sulcus and manifesting as a distal infiltrative or ulcerated mass. This typically occurs in men from the 6th to 8th decades of life, and risk factors include human papillomavirus, phimosis, presence of foreskin and poor hygiene, chronic inflammatory conditions such as lichen sclerosus, trauma, and smoking. Primary urethral malignancies including urothelial carcinoma and adenocarcinoma can occur but may lack this distal predilection. Sarcoma, melanoma, leukemia or lymphoma, and metastatic disease are less common sources of penile malignancy. Because of the sensitive nature of penile malignancies, there may be delays in seeking care and in subsequent diagnosis. Recently, the staging guidelines for penile cancer have been updated concurrently with a shift toward more penile-preserving therapies, which have led to a larger role of imaging in diagnosis, staging, and treatment planning for penile malignancies. A variety of imaging modalities may play a role in the identification and staging of penile malignancy, including an increased use of MRI for local staging of tumors, CT and PET/CT for identification of nodal and distant disease, and US for image-guided biopsy. The authors discuss an imaging approach to a spectrum of penile malignancies, with an emphasis on radiologic and pathologic correlation and how knowledge of normal tissue types and anatomic structures can aid in the diagnosis and staging of these tumors. RSNA, 2023 Quiz questions for this article are available in the supplemental material.
PubMed: 37471245
DOI: 10.1148/rg.230025 -
Indian Journal of Urology : IJU :... 2022Inguinal lymph node dissection (ILND) is an integral part in the management of carcinoma penis. The concerns about the postoperative morbidity associated with open ILND... (Review)
Review
INTRODUCTION
Inguinal lymph node dissection (ILND) is an integral part in the management of carcinoma penis. The concerns about the postoperative morbidity associated with open ILND led to modification in the template of dissection and adoption of minimally invasive techniques such as video endoscopic inguinal lymphadenectomy (VEIL) and robotic-assisted VEIL (R-VEIL). In this review, we aim to describe the techniques, case selection, perioperative outcomes, and oncological outcomes of VEIL and R-VEIL and to compare it with open ILND.
METHODS
Databases of PubMed, Embase, and Google Scholar were searched to identify the articles for VEIL and R-VEIL. Using PRISMA guidelines, literature search yielded 3783 articles, of which 32 full-text articles relevant to the topic were selected and reviewed, after consensus from authors.
RESULTS
After the first description of VEIL, various modifications in port placements and approaches were described. Several studies have shown, VEIL and R VEIL are safe and feasible in both node-negative and node-positive Ca penis patients. Compared to open ILND, VEIL had fewer wound infections and skin necrosis, minimal blood loss, shorter mean hospital stays, and reduced duration of drain kept. There is no difference in mean lymph node yield and recurrence rates between open ILND, VEIL, R-VEIL.
CONCLUSION
VEIL and R-VEIL are safe and have comparable oncological outcomes with open ILND.
PubMed: 35136290
DOI: 10.4103/iju.iju_387_21 -
European Urology Focus Mar 2023Organ-sparing surgery (OSS) is endorsed by the European Association of Urology (EAU) guidelines as the preferred treatment for distal primary penile cancer. The... (Review)
Review
Organ-sparing surgery (OSS) is endorsed by the European Association of Urology (EAU) guidelines as the preferred treatment for distal primary penile cancer. The recommendation states that OSS should be used whenever possible, without exactly defining what constitutes "possible". This recommendation is based on findings showing that this approach has no detrimental impact on survival. At the same time, OSS results in preservation of quality of life (QoL) and of various functions of the penis. However, while narrow tumor-free margins (>1 mm) are deemed oncologically safe, there is a higher risk of local recurrence. Recent data have emerged that question the dogma that a local recurrence does not impact survival outcomes. In this mini review, we highlight areas of discrepancy in current guidelines and describe challenges for a surgical approach with a delicate balance between oncological safety on the one hand and maximal preservation of QoL and penile functions on the other. PATIENT SUMMARY: Organ-sparing surgery has been recommended as the preferred treatment for primary cancer of the penis, as quality of life and sexual function are maximally preserved. In this review we identify challenges and limitations in routinely adopting this approach.
Topics: Male; Humans; Penile Neoplasms; Quality of Life; Organ Sparing Treatments; Penis; Urologic Surgical Procedures, Male
PubMed: 36653257
DOI: 10.1016/j.euf.2023.01.005 -
BMC Urology Jan 2021Verrucous carcinoma, a rare low-grade well-differentiated squamous cell carcinoma, is known for its favorable biological behavior and lack of metastatic potential....
BACKGROUND
Verrucous carcinoma, a rare low-grade well-differentiated squamous cell carcinoma, is known for its favorable biological behavior and lack of metastatic potential. However, aggressive resection is problematic in terms of compromised function and aesthetics. Hence, more conservative treatments are needed.
METHODS
To identify the up-to-date general biological behavior, diagnosis, and treatment trends, we searched PubMed using the keyword "penile verrucous carcinoma" without restrictions on publication date.
RESULTS
Current treatments for penile verrucous carcinoma include wide surgical excision, seldom preventive lymphadenectomy, and conservative chemotherapy without surgery or local excision with safe margins. Despite the advent of partial penectomy to minimally impact function and aesthetics, affected patients experience psychosexual problems. Local excision can be used to save the penile shaft and glans penis without preventive lymphadenectomy or adjuvant therapy and can achieve good clinical prognosis with rare recurrence.
CONCLUSIONS
To preserve the functional and cosmetic aspects, we recommend local excision, especially for tumors measuring < 3 cm and classified as stage T1 according to the 2016 tumor node metastasis clinical and pathological classification for penile cancer.
Topics: Carcinoma, Verrucous; Humans; Male; Penile Neoplasms
PubMed: 33514369
DOI: 10.1186/s12894-020-00777-1 -
Medicina (Kaunas, Lithuania) Jun 2022Human Papillomavirus is the main cause of cervical cancer, including squamous cell carcinoma of the oropharynx, anus, rectum, penis, vagina, and vulva. In recent years,... (Review)
Review
Human Papillomavirus is the main cause of cervical cancer, including squamous cell carcinoma of the oropharynx, anus, rectum, penis, vagina, and vulva. In recent years, considerable effort has been made to control HPV-induced diseases using either prophylactic or therapeutic approaches. A critical review of the literature about the therapeutic Human Papillomavirus vaccine was performed to analyze its efficacy in the treatment of female lower genital tract lesions and its possible perspective application in clinical practice. The most important medical databases were consulted, and all papers published from 2000 until 2021 were considered. We retrieved a group of seven papers, reporting the role of anti HPV therapeutic vaccines against the L2 protein in the order of their efficacy and safety in female lower genital tract disease. In addition, the immune response due to vaccine administration was evaluated. The development of therapeutic vaccines represents an interesting challenge for the treatment of HPV infection of the lower genital tract. Literature data underline that the L2 protein may be an interesting and promising target in the development of therapeutic HPV vaccines, but the possible strengths and the unclear longevity of L2 immune responses are factors to be considered before clinical use.
Topics: Female; Humans; Male; Papillomaviridae; Papillomavirus Infections; Papillomavirus Vaccines; Uterine Cervical Neoplasms; Vaccination
PubMed: 35888579
DOI: 10.3390/medicina58070860 -
Urology Feb 2021Gastric cancer is a rare long-term complication in gastrocystoplasty. We report 2 cases of gastric adenocarcinoma and review the literature for similar cases. A total of... (Review)
Review
Gastric cancer is a rare long-term complication in gastrocystoplasty. We report 2 cases of gastric adenocarcinoma and review the literature for similar cases. A total of 14 cases are identified. The majority of patients are males, presented with hematuria, and developed cancer at a younger age, more than 10 years after gastrocystoplasty. Long-term follow up information was limited, but 5 patients (36%) died within 5 years of diagnosis. Annual surveillance for malignancy may not be effective due to its rarity. However, symptomatic patients, particularly those 10 years after the surgery, warrant detailed evaluation to rule out neoplastic transformation.
Topics: Adenocarcinoma; Adolescent; Adult; Female; Humans; Male; Plastic Surgery Procedures; Stomach; Urethra; Urinary Bladder Neoplasms; Urinary Bladder, Neurogenic; Vesico-Ureteral Reflux; Young Adult
PubMed: 32683064
DOI: 10.1016/j.urology.2020.07.003