阴茎原发性恶性黑色素瘤1例报告并文献复习

目的探讨阴茎原发恶性黑色素瘤的生物学行为、临床病理特点、诊断治疗方法及其预后。方法报告1例阴茎原发恶性黑色素瘤的诊断治疗、随访情况并结合国内外文献进行分析。结果本例患者肿瘤分期为I期,行阴茎全切尿道会阴造口＋双侧腹股沟淋巴结清扫术,术后行化疗并结合免疫治疗,于术后18个月出现远处转移,术后30个月因全身多发转移、多器官功能衰竭死亡。结论阴茎原发恶性黑色素瘤临床罕见,恶性程度高。其确诊依靠病理,外科手术为主要治疗手段,对于Ⅰ期、Ⅱ期的患者,阴茎全切术式较之部分切除术后生存期明显延长,对于Ⅲ期患者手术范围则对于术后生存期并无明显影响。术后结合化疗以及免疫治疗可提高生存期,但总体预后差。     

Primary epithelioid hemangioendothelioma of the penis: a case report and literature review

Epithelioid hemangioendothelioma (EHE) is a rare vascular tumour with an intermediate behaviour between benign hemangioma and malignant angiosarcoma. There is scarce data on the penile EHE’s management and its natural history, as our knowledge is based on few reported cases with a short follow-up period. We present a case report and conducted a literature review, including 17 cases. The relevance of this case report derives from the need for better clinical characterization of patients with penile EHE and the importance of defining the outcomes. We report the case of a 53-year-old male with a 1-year history of sleep-related painful erections. Imaging techniques showed a well-defined hypoechoic and hypervascular solid nodule on the dorsal aspect of the penis. It was surgically removed, and the histopathological study revealed a low-risk EHE of the penis. Follow-up magnetic resonance imaging (MRI) and computed tomography did not demonstrate local recurrence nor metastases. According to the literature review, most of the patients were in their fifth and sixth decades of life at the time of diagnosis and lesions were usually located in the glans. The most common clinical presentation was as a painful mass. Follow-up period ranged from 2 months to 5 years. Three patients showed systemic metastases, two of which died due to cancer. The conclusions from the literature review are limited by the reduced number of cases and the short follow-up. This case report highlights the importance of understanding the diagnosis and treatment of this type of rare non-squamous malignant tumours of the penis. Penile EHE is a malignant vascular tumour that is very rare in this location. The best treatment is local excision, with re-excision or intraoperative margins assessment. Occasionally, systemic chemotherapy and radiation therapy can be useful. There is consensus on the importance of very strict follow-up of these patients.     

Primary malignant melanoma of the scrotum: case report and literature review

Malignant melanoma of the scrotum is the rarest of primary genitourinary melanomas, with only 3 cases reported previously. We present an additional case of this often aggressive malignancy. The pertinent literature is reviewed and the current management strategies are discussed.     

Primary malignant melanoma of the oesophagus: A case report and literature review

We report a case of primary malignant melanoma of the oesophagus (PMMO), followed by a review of recent literature. Surgical resection for operable tumours remains the current practice. In general, the prognosis of PMMO is poor, with a median survival of 10 months. Recent advances, including chemoendocrine and chemoimmunotherapy, might help improve overall survival. Combined endoscopic and systemic therapy is an alternative for patients unfit for surgery, or in patients with metastatic disease.     

Primary renal malignant fibrous histiocytoma: a case report and literature review

Malignant fibrous histiocytoma has been reported as a primary renal tumor in 7 cases, of which 4 had relevant clinical histories and followup. We report an additional case noting, as others have, the similarity in clinical presentation with renal cell carcinoma. Despite a radical operation this tumor often manifests local recurrence with subsequent distant metastases.     

Angiosarcoma of the penis:a case report and literature review

We reported one case of penile angiosarcoma in a 49-year-old patient who had been misdiagnosed as syphilis. Based on our experience, we suggest that if sexually transmitted diseases and Peyronie's disease can be ruled out, diagnosis of the penile angiosarcoma be warranted if unexplained rash, ulceration on the penis, and induration in corpus cavernosum are observed. It should be noted that if the anti-inflammatory or anti-viral treatment is prescribed for some time but the lesion does not disappear or even gets worse, the penile angiosarcoma should be suspected and penile biopsy is necessary.     

Primary malignant teratoma of the kidney: a rare case report and literature review

Teratomas originate from pluripotent cells and can differentiate along one or more embryonic germ lines. Renal teratoma is infrequent and malignant renal teratoma is even rarer. Experience in the diagnosis and treatment of this uncommon malignancy is seriously limited. In this report, we described the case of a 64-year-old female who complained of right flank pain for 4 months. Computed tomography (CT) revealed a hypodense mass (50 mm in maximum diameter) with slow contrast enhancement and obscure boundary located in the lower pole of the right kidney. CT also showed multiple retroperitoneal lymphadenectasis. Retroperitoneal laparoscopic right radical nephrectomy along with regional lymphadenectomy was successfully performed, and postoperative pathological examination confirmed malignant teratoma of the kidney. After surgery, the patient received adjuvant chemotherapy with BEP (bleomycin, etoposide, and cisplatin) protocol. At the 6-month follow-up, pulmonary and liver metastases were discovered by CT and the patient refused any further treatment. Unfortunately, she died at 16 months postoperatively. Although primary renal malignant teratoma is extremely rare, this kind of tumor should be taken into consideration. Currently, there is no therapeutic standard consensus for this disease and the prognosis remains unclear. Early detection and surgical intervention is critical, and more research on postoperative adjuvant therapy should be performed.     

Primary malignant peritoneal mesothelioma. A report of seven cases and a review of the literature

Mesothelioma of the peritoneum is a rare malignant neoplasm easily mistaken by both surgeon and pathologist for one of the more common neoplasms of the abdomen. Review of our records from metropolitan-area hospitals for the past 15 years identified seven patients with primary peritoneal mesotheliomas. Their diagnosis, management, and survival is analyzed. We report a case of an extended survivor (7 years) and one of a long-term survivor (15 years), as well as what we believe to be the only case in the literature presenting with a coexistent malignant neoplasm. Prevention of this commonly fatal neoplasm is linked to avoiding occupational exposure to asbestos; long-term survival for a few patients may be achieved with correct identification of the neoplasm and aggressive management. This report includes a review of the literature.     

恶性腹膜间皮瘤长期生存1例报告并文献复习

恶性腹膜间皮瘤为一极具侵袭性的原发性腹膜肿瘤,病因不明,无典型临床表现,诊断困难,预后不佳.但自实施肿瘤减积术为主的综合治疗后,生存期明显延长.笔者报告1例术后14年生存者.     

Primary malignant melanoma of the lung: review of literature and report of a case

Less than 25 cases of primary malignant melanoma of the lung have been reported in the literature, with limited mention in the surgical literature. When published criteria are strictly applied, the actual number of cases is even fewer. We report the case of a 74-year-old man who underwent a left lower pulmonary lobectomy for a large left lower lobe mass consistent with malignancy. Clinical and pathological review confirmed primary malignant melanoma of the lung. Relevant clinical and histopathological features and the criteria for diagnosis are reviewed.     

女性尿道原发性恶性黑色素瘤1例并文献复习

目的 结合文献资料复习,提高女性原发性尿道恶性黑色素瘤的诊疗水平.方法 回顾性分析1例女性原发性尿道恶性黑色素瘤患者临床资料.结果 病例行尿道癌根治术+回肠膀胱术,术后病理证实为尿道恶性黑色素瘤,浸及尿道全层及阴道浆膜面,阴道黏膜及肌层未见癌,膀胱、双侧附件、子宫体、宫颈未见癌,双侧盆腔淋巴结未见转移癌.已随访1年,...     

Peritoneal malignant mesothelioma: case report

Our study reports peritoneal diffuse malignant mesothelioma (DMM) in a 43 years old male patient, with no exposure to asbestos in his medical history; the partner of the patient was also not exposed to asbestos. The exposure to X-rays was also excluded. Different pathogenic mechanisms for the pathogenesis of a peritoneal diffuse malignant mesothelioma in this patient can be hypothesized, for example, SV40 infection and genetic susceptibility; a minimal domestic exposure to asbestos can be not excluded. Therefore, further studies in a larger number of subjects are necessary to determine whether one or all of these hypothetic pathogenic mechanisms are more significant for the development of malignant mesothelioma.     

Primary malignant melanoma of female urethra: report of a case and review of the literature

We report herein one case of malignant melanoma with a survival period of more than four years, refer to its recent conception on histopathological and ultrastructural problems and its treatment, and review the literature.     

Primary renal malignant fibrous histiocytoma. A case report and review of the literature

Primary renal malignant fibrous histiocytoma is a rare tumor of the kidney. We report an additional case noting, as other authors have, the similarity in clinical presentation with renal cell carcinoma. We also review the 23 documented cases of the international literature, emphasizing the current diagnostic approaches and therapeutic management.     

Tuberculosis of the penis: report of a case and review of the literature

Tuberculosis of the penis is a rare disease. We report a case of tuberculosis of the penis. A 51-year-old man noticed a painless induration with a central ulceration on the glans penis. He had a history of tuberculosis of cervical lymph-nodes, right epididymis and leg skin. Examination of the other parts showed no evidence of tuberculosis. Tuberculin test was strongly positive. The skin lesion of the glans was excised. The pathology was epithelioid cell granuloma with Langhans' giant cell, indicative of tuberculosis. But acid-fast bacilli were not detected in the Ziehl-Neelsen preparation of the tissue. The patient was treated with isoniazid, rifampicin and cycloserine. After the treatment for approximately 5 months, recurrence was not observed and enlargement of cervical lymphadenopathy improved. We reviewed 39 cases of tuberculosis of the penis reported in Japan during the past 14 years.     

Primary malignant lymphoma of the bladder. A case report and review of the literature

Primary malignant lymphoma of the bladder is unusual. We report a case of primary malignant lymphoma arising in the urinary bladder. A 54-year-old woman was admitted to our hospital with the chief complaint of dysuria, on May 26, 1995. Examination of IVP, ultrasonography, cystoscopy suggested a non-papillary bladder tumour. Diagnosis was established by histological examination.