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Organo Oficial de la Sociedad Mexicana de Urología

2010, Number 5

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Rev Mex Urol 2010; 70 (5)

Bilateral laparoscopic inguinal and pelvic lymphadenectomy in sarcomatoid cancer of the penis

Shuck-Bello CE, Morales-Montor JG, Camarena-Reynoso HR, Leos-Acosta CA, Cantellano-Orozco M, Parraguirre-Sara, Pacheco-Gabhler C, Calderón-Ferro F

Language: Spanish
References: 23
Page: 319-324
PDF size: 2204.00 Kb.


ABSTRACT

Squamous cell cancer of the penis is a rare pathology in Europe and the United States, representing 0.4-0.6% of all cases of neoplasia. The presence and extension of lymphatic metastases is the most important prognostic factor with a percentage of 28-64%. Sarcomatoid differentiation (metaphasic or biphasic signet ring cells) is a rare variant arising in epithelial cells and presents in 4% of all cases of cancer of the penis. It is characterized by its aggressive and rapid metastatic behavior, especially to the bone, lung, and pericardium. It has short-term poor prognosis.
The present case is a 65-year-old man with a previous history of ocular trauma leading to amaurosis. Present disease had 2-month progression and was characterized by a non-painful, hard, exophytic, vegetative lesion in the glans penis of approximately 3 cm causing dysuria and hematuria upon completing micturition as well as prepuce deformity. Total phallectomy was performed in May 2009 and histopathological report stated ulcerated sarcomatoid epidermoid carcinoma in the glans penis measuring 4.4 x 3.7cm, with invasion of the corpus spongiosum and urethral meatus and stage T3N0M0 vascular permeation. Bilateral laparoscopic inguinal and pelvic lymphadenectomy was carried out in response to invasion of one right obturator lymph node and epidermoid carcinoma of the penis invasion that was managed with adjuvant chemotherapy.


REFERENCES

  1. Protzel C, Alcaraz A, Horenblas Set al. Lymphadenectomy in the surgical management of penile cancer. Eur Urol. 2009 May; 55(5):1075-88.

  2. Horenblas S. Lymphadenectomy for squamos cell carcinoma of the penis. Part 2: the role and technique of lymph node dissection. BJU Int 2001;88:473-83.

  3. Ornellas AA, Seixas AL, Marota A et al. A prospective study of 100 cases of penile cancer managed according to European Association of Urology guidelines. BJU Int 2006;98:526-31.

  4. Lont AP, Gallee MP, Snijders P, Horenblas S. Sarcomatoid squamous cell carcinoma of the penis: a clinical and pathological study of 5 cases. J Urol 2004;172:932-5.

  5. Velásquez FE, Relamed J, Barreto JE et al. Sarcomatoid carcinoma of the penis. A clinicopathologic study of 15 cases. Am J Surg Pathol 2005;29:1152-8.

  6. Hungerhuber E, Schlenken B, Karl A et al. Risk stratification in penile carcinoma: 25-year experience with surgical inguinal lymph node staging. Urology 2006;68:621-5.

  7. Lont AP, Kroon BK, Maarten P, et al. Pelvis lymph node dissection for penile carcinoma: extent of inguinal lymph node involvement as an indicador for pelvis lymph node involvement and survival. J Urol 2007;177:947-52.

  8. Slaton JW, Morgenstern N, Levy DA, et al. Tumor stage, vascular invasión and the percentage of poorly differentiated cancer: independent prognosticators for inguinal lymph node metastasis in penile squeamos cancer. J Urol 2001;165:1138-42.

  9. Novara G, Artibani W, Cunico AC, De Giorgi G. How accurately do Solsona and European Association of Urology risk groups predict for risk of lymph node metastases in patients with squeamous cell carcinoma. Urology 2008;71:328-33.

  10. Leijte JA,Horenblas S. Shortcomings of the current TNM classification for penile carcinoma: time for a change? World J Urol 2009;27:151-4.

  11. Theodorescu D, Russo P, Zhang ZF, et al. Outcomes of inicial surveillance of invasive squamous cell carcinoma of the penis and negative nodes. J Urol 1996;155:1626-31.

  12. Kroon BK, Horenblas S, Lont AP, et al. Patients with penile carcinoma benefit from immediate resection of clinically occult lymph node metastases. J Urol 2005;173:816-9.

  13. Solsona E, IborraI, Rubio J, et al. Prospective validation of the association of local tumor stage and grade as a predictive factor for occult lymph node micrometastasis in patients with penile carcinoma and clinically negative inguinal lymph nodes. J Urol 2001;165:1506-9.

  14. Protzel C, Knoedel J, Wolf E, et al. Prognostic parameters of penis carcinoma. Urologe A 2007;46:1162.

  15. Catalona WJ. Modified inguinal lymphadenectomy for carcinoma of the penis with preservation of saphenous veins: technique and preliminary results. J Urol 1988;140:306-10.

  16. Bouchot O, Rigaud J, Maillet F, et al. Morbidity of inguinal lymphadenectomy for invasive penile carcinoma. Eur Urol 2004;45:761-5.

  17. Lopes A, Rossi BM, Fonseca FP, Moroni S. Unreliability of modified inguinal lymphadenectomy for clinical staging of penile carcinoma. Cancer 1996;77:2099-102.

  18. Wespes E, Simon J, Schulman CC. Cabanas approach: is sentinel node biopsy reliable for staging penile carcinoma? Urology 1986;28:278-9.

  19. Tanis PJ, Lont AP, Meinhardt W, et al. Dynamic sentinel node biopsy for penile cancer: reliability of a staging technique. J Urol 2002;168:76-80.

  20. Kroon BK, Horenblas S, Estourgie SH, et al. How to avoid false-negative dynamic sentinel node procedures in penile carcinoma. J Urol 2004;171(6 Pt 1):2191-4.

  21. Ficarra V, Galfano A. Should the dynamic sentinel node biopsy (DSNB) be considered the gold Standard in the evaluation of lymph node status in patients with penile carcinoma? Eur Urol 2007;52:17-9.

  22. Tobias-Machado M, Tavares A, Ornellas AA, et al. Video endoscopic inguinal lymphadenectomy: a new minimally invasive procedure for radical management of inguinal nodes in patients with penile squamous cell carcinoma. J Urol 2007;177:953-7

  23. Sotelo R, Sanchez-Salas R, Carmona O, et al. Endoscopic lymphadenectomy for penile carcinoma. J Endourol. 2007;21:364




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