阴茎原发恶性黑色素瘤4例

目的 探讨阴茎原发恶性黑色素瘤的临床症状、病理特点及诊断治疗.方法 对4例阴茎原发恶性黑色素瘤的病理和临床资料进行回顾性分析.结果 4例均行阴茎部分切除,双侧腹股沟淋巴结清扫术.术后4例均行化疗,其中2例化疗联合生物学治疗.结论 阴茎原发恶性黑色素瘤临床罕见,确诊依靠病理,手术为主要治疗手段,术后行化疗联合生物学治疗可提高生存期,但因其恶性程度高,预后不佳.     

阴茎恶性黑色素瘤1例报告

阴茎黑色素瘤临床少见。本文报道1例,患者因阴茎外伤20个月,发现阴茎肿物14个月入院,行阴茎肿物切除＋左侧腹股沟淋巴结活检术,病理示阴茎恶性黑色素瘤,左侧腹股沟淋巴结转移。后行双侧髂腹股沟淋巴结清扫术,病理示双侧髂腹股沟淋巴结转移。术后行帕博利珠单抗治疗17个周期。术后随访22个月,未出现疾病进展。     

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。     

阴茎部分切除加腹腔镜腹股沟淋巴结清扫治疗男性尿道黑色素瘤1例报告

<正>尿道黑色素瘤极为罕见,我科对1例男性尿道黑色素瘤采取阴茎部分切除加腹腔镜下双侧腹股沟淋巴结清扫术,术后配合免疫治疗,效果良好,现报道如下。1 临床资料患者,男性,65岁,1年余前,出现排尿费力, 未加以重视。4个月余前, 发现左侧腹股沟肿块,呈进行性增大。 1个月余前至我院就诊, B超检查提示左腹股沟异常淋巴结,行左腹股沟淋巴结活检,病理提示: 转移性恶性黑色素瘤。体表皮肤检查,胸部、腹部、盆腔CT,肠镜等检查未发现原发病灶。1     

腹股沟前哨淋巴结活检在阴茎癌治疗中的价值

目的 探讨腹股沟前哨淋巴结活检在阴茎癌手术治疗及二期髂腹股沟淋巴结清扫的意义. 方法 对阴茎癌患者在手术切除原发病灶的同时,行双侧腹股沟淋巴结活检,以确定其性质. 结果 46例阴茎癌患者中,高分化鳞癌25例,中分化鳞癌18例,低分化鳞癌3例.其中42例行前哨淋巴结活检,20例活检阳性,二期行髂腹股沟淋巴结清扫术;另22例阴性,其中淋巴结炎症及反应性增生者16例,密切观察随访. 结论 对阴茎癌患者手术切除原发病灶,同时作双侧腹股沟前哨淋巴结活检,对确定其有无转移及进一步对活检阳性者行髂腹股沟淋巴结清扫术具有重要的价值.     

阴茎恶性黑色素瘤1例报告并文献复习

目的认识阴茎恶性黑色素瘤的生物学行为和临床病理特征。方法回顾分析1例阴茎恶性黑色素瘤病例,结合文献分析其发病情况、临床病理特征、诊断和治疗。结果患者行阴茎部分切除术,术后1年死于肺转移。免疫组化染色(S-P法):HMB45( ),S-100( ),Vimentin( ),Actin(SM)(-),Cytokeratin(-)。结论阴茎恶性黑色素瘤治疗主要采用手术切除,辅以放疗、化疗及免疫治疗,但预后差。     

腹股沟淋巴结清扫术在阴茎癌治疗中的作用

目的:探讨腹股沟淋巴结清扫术在阴茎癌治疗中的作用,为临床治疗阴茎癌提供成功案例.方法:对15例阴茎癌而接受腹股沟淋巴结清扫术的患者进行临床治疗观察.结果:术后病理检查均发现13例有腹股沟淋巴结转移,2例有淋巴结增大,均诊断为鳞状细胞癌.结论:阴茎癌容易并发腹股沟淋巴结转移,建议常规行预防性腹股沟淋巴结清扫术,这有助于提高患者的生存率.     

髂腹股沟淋巴清扫对阴茎癌的治疗意义(附63例报告)

目的 探讨腹股沟淋巴结活检脑髂腹肌沟淋巴清扫在阴茎癌治疗中的作用.方法 报告1982年1月１９９７年７月收治的６３例陈茎癌的临床资料,在节切除阴茎原发病灶同时行无选择性双侧腹股沟淋巴结活检,并对淋巴结活检阳性者行双侧髂腹股沟淋巴清扫术。结果 １１例（１５侧）淋巴结活检阳性,１例假阴性。淋巴清扫后,原活检阴性侧髂腹股沟未见淋巴转移,阳性侧有１例,存在Ｃｌｏｑｕｅｔ淋巴结转移。结论 在切除阴茎癌肿的同时应作双     

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,...     

阴囊Paget病的诊治分析(附23例报告)

目的:探讨阴囊Paget病的诊断、治疗、复发因素及预后,提高诊治水平。方法:回顾性分析本院1996～2008年诊治的阴囊Paget病患者的临床资料。结果:23例患者中,局限于一侧阴囊者15例,累及双侧阴囊及阴茎者8例;病变同侧腹股沟淋巴结肿大者3例(2例术后病理证实为转移癌,1例为炎症),双侧腹股沟淋巴结肿大者2例(1例术后病理证实为转移癌,1例为慢性炎症改变)。全部病例均经活检明确诊断,并均行手术治疗。术后定期随访2～68个月,其中术后局部复发5例,因远处转移死亡2例。结论:活检是早期诊断阴囊Paget病重要方法,病变处阴囊的早期广泛切除是治疗阴囊Paget病的首选治疗手段。     

A case of malignant melanoma of the penis

An 83-year-old male presented in October, 1988, with pigmented tumor lesions on the penis. The main tumor mass accompanied with necrotic bleeding, measuring 5 cm in diameter was located on the fore skin and glans penis. On the proximal shaft of the penis, there were three other black tumors, measuring from 0.5 to 3 cm in diameter. The distal urethra of the penis was clinically involved in the tumor mass and bilateral inguinal lymph nodes were palpable. Chest X-ray and liver scan both revealed multiple metastases. Tumor biopsy confirmed malignant melanoma. Phallectomy and bilateral inguinal lymph node biopsies were performed in October, 1988. Pathological findings revealed that a malignant melanoma had developed from the fore skin and glans penis, extended into the penile urethra and metastasized to bilateral inguinal lymph nodes. The patient gradually deteriorated in general condition and died of cancer 28 days later. The prognosis of malignant melanoma of the penis seems to be extremely poor.     

A case of penile malignant melanoma

A 79-year-old male presented in December. In January, 2001, with complaints of black nodules and bleeding from the glans of the penis to the foreskin. Inguinal lymph nodes were palpable bilaterally. Clinical diagnosis was penile malignant melanoma. Cystoscopy and urethrography revealed urethral invasion of malignant melanoma, and magnetic resonance imaging (MRI) of the penis revealed invasion to prostate, and pelvic lymph node metastases in abdominal compuled tomography (CT) but no organ metastases. Total cystectomy, total penectomy, bilateral inguinal and pelvic lymph node dissection and bilateral ureterocutaneostomy were performed in February, 2002. The pathological findings were nodular malignant melanoma, pT4bN2bM1a, and the surgical margin was positive. After these therapies, chemotherapy was performed. Five months later, CT revealed multiple lung and brain metastases, and radiation therapy and chemotherapy were performed. Twelve months after the operation, he died of cancer. Review of the literature revealed that our patient is the thirtieth reported case of penile malignant melanoma in Japan since 1924. In 30 cases, stage III, IV were 20 cases and 16 cases performed operation.     

Recurrent malignant melanoma of the penis

We report the case of a 72-year-old man with arcal-lentiginous type melanoma of the penis who had undergone local excision and bilateral inguinal lymphadenectomy but developed recurrence at the subcoronal ridge of the glans penis. To our knowledge, this is the 10th reported case in English published studies. We believe this case demonstrates the importance of close follow-up postoperatively and to beware of the recurrence of penile melanoma in patients without total penectomy.     

A case of malignant melanoma of the penis

We experienced a 53-year-old male with malignant melanoma of the penis. A lentigo was noted in the dorsal penis in 1980. On February 4, 1982, he was referred to our Hospital with the complaint of enlargement of the lentigo of the penis and swelling of the bilateral inguinal lymph nodes. Lymph node biopsy disclosed metastasis of the malignant melanoma. He was hospitalized for treatment of the lesion. On physical examination at admission, a black tumor, 3 cm in diameter, with necrosis at the center and unclear demarcation was observed in the dorsal part, very close to the coronal sulcus, slightly to the left. Many black spots were scattered around the tumor. Curative operation could not be expected because of metastasis to the lymph nodes and the lung. Combination chemotherapy with DTIC, ACNU and vincristine, and immunotherapy were carried out. CT scan, lymphangiography and intravenous pyelography confirmed right hydronephrosis due to compression of enlarged retroperitoneal lymph nodes. Agenesis of the left kidney was confirmed through these evaluations. Right ureterostomy was performed and a metastatic lesion was identified in the resected ureter. After the operative treatment, chemotherapy and immunotherapy were performed again, but their effects were limited, and he died on May 6, 1982. Metastatic lesions in the lungs, liver, brain, skin and agenesis of the left kidney were confirmed by autopsy. Eleven malignant melanomas of the penis including our case have been reported in the Japanese literature. This case is considered to be secondary to an ureter tumor.     

Fine-needle aspiration cytology predicts inguinal lymph node metastasis without antibiotic pretreatment in penile carcinoma

OBJECTIVE: To evaluate the accuracy of fine-needle aspiration (FNA) cytology of palpable inguinal lymphadenopathy before definitive management of the primary tumour, in predicting inguinal lymph node (LN) metastasis in men with primary squamous cell carcinoma (SCC) of the penis. PATIENTS AND METHODS: Sixteen men with primary SCC of the penis and palpable inguinal lymphadenopathy (unilateral or bilateral) were treated by primary resection and bilateral inguinal LN dissection. FNA cytology was analysed for 25 palpable inguinal LNs at the time of penile biopsy. The sensitivity, specificity and accuracy of FNA cytology was compared with the histological findings from surgical LN clearance. RESULTS: The 25 FNAs were without complication and without evidence of implantation of metastasis in the needle tracts; 14 FNA samples were positive for metastasis, 10 were negative, and one was inconclusive. From the histological assessment of the surgical inguinal LN specimens, FNA cytology had a sensitivity of 93%, and specificity of 91% in predicting metastatic disease. CONCLUSION: FNA cytology of palpable inguinal lymphadenopathy before surgery for the primary tumour has a high sensitivity and specificity for metastatic penile cancer. This procedure permits early inguinal lymphadenectomy where appropriate without need for prolonged initial antibiotic treatment.     

Primary malignant melanoma of male urethra

A case of primary malignant melanoma of the male urethra is reported. Treatment included partial urethrectomy, bilateral inguinal and iliac lymphadenectomy, and post-surgical systemic chemotherapy. After thirty-six months, the patient is alive with cutaneous, pelvic lymph node, and gastric metastases.     

Primary malignant melanoma of the penis. Two cases and a review of the literature.

Two cases of primary malignant melanoma of the penis are reported and 35 cases from the world literature are reviewed. The tumour most commonly started in the glans penis and less frequently from the prepuce. The microscopic appearances were identical with those of tumours arising elsewhere in the skin. A comparison is made between the incidence of melanoma of the penis and melanoma occurring elsewhere on the body surface. Evaluation of the best treatment was difficult because the total number of cases was small and the methods of treatment and results so variable. It would seem that the prognosis of malignant melanoma of the penis is generally poor, although there are sufficient examples of long-term survival after total amputation in Stage I disease to suggest that this radical treatment is justified.     

女性尿道原发性恶性黑色素瘤3例报告

目的：探讨女性尿道原发性恶性黑色素瘤的临床特征及治疗手段。方法：对3例女性原发性尿道恶性黑色素瘤进行临床病理分析及随访观察。结果：3例均以尿道外口包块就诊。2例因术前诊断不清，仅局部切除，其中1例术后半年死于肿瘤复发。1例正在随访中；1例行全尿道切除，双侧腹股沟淋巴结清扫及永久性膀胱造瘘。结论：女性尿道原发性恶性黑色素瘤恶性度高，临床易误诊，早期确诊的主要依据是病理学检查，及时规范手术是提高患者生存率的主要手段。