Conservative surgery using scrotal skin for invasive penile carcinoma: Case report and brief review of the literature (original) (raw)
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Penile Squamous Cell Carcinoma in a 95-Year-Old Patient: Case Report and Literature Review
Cureus
Penile cancer is a rare disease. Delay in diagnosis and treatment frequently occurs and high morbidity can be observed in affected patients. The management is based on surgical resection. The inguinal node staging depends on the disease-related risk. We herein report a 95-year-old male patient, with a history of a right inguinal hernia, surgically treated. He presented with a swollen painful glans penis. The glans biopsy identified a moderately differentiated invasive squamous cell carcinoma. We have performed a complete penectomy with a bilateral inguinal lymph node dissection. The patient is currently receiving adjuvant chemotherapy based on cisplatin Categories: Urology, Oncology
Morbidity of Inguinal Lymphadenectomy for Invasive Penile Carcinoma
European Urology, 2004
Objective: To determine the incidence and the consequences of complications related to modified and radical inguinal lymphadenectomy in patients with invasive penile carcinoma, defined by invasion of the corpus spongiosum or cavernosum (T2). Materials and Methods: A total of 118 modified (67.0%), and 58 radical (33.0%) inguinal lymphadenectomy were performed in 88 patients between 1989 and 2000. To decrease the morbidity, radical inguinal lymphadenectomy was proposed only in patients with palpable inguinal lymph nodes, uni-or bilaterally (N1 or N2). Modified inguinal lymphadenectomy was performed bilaterally in patients with invasive penile carcinoma and non-palpable inguinal lymph nodes (N0), and unilaterally in the side without inguinal metastases in N1 patients. Complications were assessed retrospectively with a median follow-up of 46 months and classified as early (event observed during the 30 days after the procedure) or late (event present after hospitalisation or after the first months). Results: A total of 74 complications after 176 procedures were recorded. After modified inguinal lymphadenectomy, 8 early (6.8%) and 4 late (3.4%) complications were observed. There were a total of 110 dissections with no complications and 8 dissections with 1 or 2 complications. After radical inguinal lymphadenectomy, the morbidity increased with 24 early (41.4%) and 25 late (43.1%) complications, observed in only 18 of 58 radical procedures. Leg oedema was the most common late complication, interfering with ambulation in 13 cases (22.4%). Conclusion: Modified inguinal lymphadenectomy, with saphenous vein sparing and limited dissection offers excellent functional outcome in patients with invasive penile carcinoma and nonpalpable inguinal lymph nodes. The morbidity after radical lymphadenectomy still significant, especially in patients with multiple or bilateral superficial inguinal lymph nodes treated by pelvic and bilateral inguinal lymphadenectomy. #
Lymphadenectomy in the Surgical Management of Penile Cancer
European Urology, 2009
e u r o p e a n u r o l o g y 5 5 ( 2 0 0 9 ) 1 0 7 5 -1 0 8 8 a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e u r o p e a n u r o l o g y . c o m Please visit www.eu-acme.org/ europeanurology to read and answer questions on-line. The EU-ACME credits will then be attributed automatically.
Anatomic Aspects of Inguinal Lymph Nodes Applied to Lymphadenectomy in Penile Cancer
Advances in Urology, 2011
Objectives. To provide a better understanding of the distribution of inguinal nodes in order to prevent the complications of unnecessary and extended dissections in penile cancer.Methods. The bilateral inguinal regions of 19 male cadavers were dissected. Nodal distribution was noted and quantified based on anatomical location. The superficial nodes were subdivided into quarters as follows: superomedial, superolateral, inferomedial, and inferolateral. Statistical analysis was performed comparing node distribution between quarters using one-way analysis of variance (ANOVA), and the unpairedT-test was used between superficial and deep nodes.Results. Superficial nodes were found in all inguinal regions studied (mean = 13.60), and their distribution was more prominent in the superomedial quarter (mean = 3.94) and less in the inferolateral quarter (mean = 2.73). There was statistical significance between quarters when comparing the upper group with the lower one (P=0.02). Nodes were widel...
The Journal of Urology, 2014
Purpose: We reviewed our recent experience with inguinal lymph node dissection in patients with penile cancer to assess the incidence and magnitude of complications caused by this procedure. Materials and Methods: Radical bilateral inguinal lymphadenectomy was performed in 170 patients (340 procedures). Prophylactic and therapeutic radical inguinal lymphadenectomy was done in 67 (39.4%) and 103 patients (60.6%), respectively. Operative time and length of hospital stay were examined. Complications were divided into minor and major, and early (30 days or less after surgery) and late (greater than 30 days), and analyzed. Results: A total of 35 complications (10.3%) were observed, of which 25 (71.4%) were minor and 10 (28.6%) were major. We noted lymphedema in 14 patients (4.1%), seroma in 4 (1.2%), scrotal edema in 3 (0.9%), skin edge necrosis in 3 (0.9%), lymphocele in 3 (0.9%), wound infection in 2 (0.6%), flap necrosis in 2 (0.6%), wound abscess in 2 (0.6%) and deep venous thrombosis in 2 (0.6%). There was no significant difference in complication rates between patients treated with prophylactic vs therapeutic dissection. Mean hospital stay was 6.4 days (range 4 to 27). Average operative time for radical unilateral inguinal lymphadenectomy was 94 minutes. Conclusions: Our contemporary series includes a lower incidence of complications, such as wound infection, skin flap necrosis, lymphocele and lymphedema. To our knowledge this series represents the lowest incidence rate of complications described in the international literature.
Justification of Inguinal Lymphadenectomy in Management of Carcinoma Penis
Journal of Evidence Based Medicine and Healthcare, 2019
BACKGROUND Diagnosing penile cancer and grading the same with available diagnostic tools is not difficult, but the problem lies in the management and more so in groin node dissection. Lymphadenectomy is the treatment of choice in patients presenting with positive node at the time of diagnosis, but problem arises in deciding node negative patients. Our aim was to evaluate role of prophylactic inguinal lymphadenectomy in carcinoma of penis. METHODS This was a prospective study carried out at MKCG Medical College and Hospital from 2012 to 2017. The clinical, diagnostic and follow-up data were collected from patient records. RESULTS A total 30 cases of penile carcinoma were included in the present study. Youngest patient was 29 years of age and oldest was of 78 years. 18 patients showed inguinal lymphadenopathy at the time of diagnosis. FNAC showed node positivity in 10 cases. 2 out of 8 cytologically negative lymph nodes for metastatic deposits came out to be positive after biopsy. Histologically majority diagnosed as moderately differentiated squamous cell carcinoma and were in stage 2. 2 patients diagnosed as verrucous carcinoma. Radical inguinal lymphadenectomy was done in all patients with cytologically proven metastatic deposits, modified radical dissection done in cytologically negative lymphadenopathy cases. In remaining patients of carcinoma penis, without inguinal node involvement, an individualistic approach was undertaken.
Endoscopic inguinal lymphadenectomy in penile cancer: case report and literature review
Objectives: The objective was to submit our first experience in endoscopic inguinal lymphadenectomy (EIL), evaluate the feasibility of the procedure and carry out a review of the literature. Material and methods: A 41-year-old patient was diagnosed with penile cancer with squamous cell carcinoma pT2G1 pathology, with no palpable inguinal lymph nodes. A bilateral inguinal lymphadenectomy was performed with preservation of the saphenous vein, conventional left and endoscopic right procedures. The perioperative data is presented and that obtained is discussed in the literature. Results: The total time was 270 minutes, 180 for endoscopic and 90 for conventional procedures. Blood loss was minimal in both cases. Fifteen lymph nodes were dissected on the endoscopic side, and 17 in the conventional side, the latter with more pain and devitalised skin flap. Conclusions: EIL for penile cancer is feasible and there is less morbidity with an early recovery. The literature is not conclusive on the indication of EIL.