阴茎疣状癌的临床诊断和治疗

为了探讨阴茎癌的少见类型疣状癌的临床诊断和治疗,结合文献回顾性分析6例阴茎疣状癌的临床资料.6例患者全部为包皮过长或包茎,肿块直径0.4～6cm;基底位于包皮内板2例,局限于龟头3例,侵犯冠状沟近侧1例;3例经活检确诊,1例误诊为乳头状瘤,1例经反复复发切除4次尚确诊.所有患者均经手术治疗,其中阴茎部分切除4例,包皮环切1例,局部切除1例.所有患者均未行腹股沟淋巴结清除以及放化疗.行包皮环切的1例患者,术后3个月发现阴茎结节,活检确诊为前次手术结扎线头的炎症反应,随访至今3年,未见复发;其余患者随访0.5～8年,1例患者自然死亡,其余患者均未见肿瘤复发或转移.初步研究结果提示,阴茎疣状癌细胞分化良好,以局部侵袭性生长为主,几乎不发生淋巴结等远处转移,活检方法不当易于误诊,恰当的手术切除效果肯定,应最大限度保留阴茎外观和功能,但术后应严密观察局部复发.     

外阴疣状癌3例并文献复习

目的：探讨外阴疣状癌的发病因素、临床表现、诊断及治疗。方法：回顾分析我院自1989年至今共收治3例外阴疣状癌的临床资料,并结合文献进行探讨。结果：3例疣状外阴癌均为老年,均来自经济落后、卫生条件较差的地区,且早婚、早育、多产,3例都通过2次以上活检确诊。其中2例手术治疗效果较好,术后才确诊为外阴疣状癌,1例第二次活检确诊为外阴疣状癌,放弃治疗死亡。结论：外阴疣状癌临床过程长,远处转移较少,预后较好,临床可疑病例应尽早活检,临床检查与病理结果不相符时建议活检组织要够深,防止误诊。必要时可多次活检以免漏诊。     

外阴疣状癌3例并文献复习

目的:探讨外阴疣状癌的发病因素、临床表现、诊断及治疗.方法:回顾分析我院自1989年至今共收治3例外阴疣状癌的临床资料,并结合文献进行探讨.结果:3例疣状外阴癌均为老年,均来自经济落后、卫生条件较差的地区,且早婚、早育、多产,3例都通过2次以上活检确诊.其中2例手术治疗效果较好,术后才确诊为外阴疣状癌,1例第二次活检确诊为外阴疣状癌,放弃治疗死亡.结论:外阴疣状癌临床过程长,远处转移较少,预后较好,临床可疑病例应尽早活检,临床检查与病理结果不相符时建议活检组织要够深,防止误诊.必要时可多次活检以免漏诊.     

阴茎疣状癌5例临床分析

目的探讨阴茎癌的特殊类型疣状癌的术前诊断和手术方法。方法回顾性分析5例阴茎疣状癌患者的临床、病理资料。结果 5例患者均包茎或包皮过长;肿瘤直径1.0～3.5 cm;基底位于阴茎头部4例,其中侵犯冠状沟近侧1例;位于包皮内板1例。5例均在术前活检确诊。3例行阴茎部分切除术;2例行肿瘤局部切除术,其中1例术后9月复发再行阴茎部分切除术;1例行腹股沟淋巴结活检。病理检查见肿瘤细胞分化好,标本切缘阴性。4例随访0.5-7年未见复发,二次手术者随访6年无复发。结论阴茎疣状癌细胞分化良好,生物学特性为局部侵袭性生长,很少发生区域淋巴结或远处转移。     

阴茎癌32例诊治体会

目的：探讨阴茎癌有效合理的诊断及治疗方法。方法：回顾性分析32例阴茎癌患者的临床资料,其中鳞状细胞癌29例,鳞状上皮乳头状瘤恶变2例,疣状癌1例。31例行手术治疗,首次治疗行单纯肿瘤切除＋包皮环切术＋放疗3例,阴茎部分切除术27例,阴茎全切＋尿道会阴部造口术1例,其中行双侧腹股沟淋巴结清扫术4例。结果：28例获得随访,行单纯肿瘤切除＋包皮环切术中1例于手术后3年复发和2例于手术后3月复发而行阴茎部分切除术,行阴茎部分切除术者2年和5年及10年生存率分别为92%、82%和45%,行阴茎全切除术者随访6年至今仍健在。结论：阴茎部分切除术是治疗阴茎癌合理有效的方法,且应尽早治疗。证实有淋巴结转移者应积极行腹股沟淋巴结清扫术。     

阴茎癌32例诊治体会

目的:探讨阴茎癌有效合理的诊断及治疗方法。方法:回顾性分析32例阴茎癌患者的临床资料,其中鳞状细胞癌29例,鳞状上皮乳头状瘤恶变2例,疣状癌1例。31例行手术治疗,首次治疗行单纯肿瘤切除+包皮环切术+放疗3例,阴茎部分切除术27例,阴茎全切+尿道会阴部造口术1例,其中行双侧腹股沟淋巴结清扫术4例。结果:28例获得随访,行单纯肿瘤切除+包皮环切术中1例于手术后3年复发和2例于手术后3月复发而行阴茎部分切除术,行阴茎部分切除术者2年和5年及10年生存率分别为92%、82%和45%,行阴茎全切除术者随访6年至今仍健在。结论:阴茎部分切除术是治疗阴茎癌合理有效的方法,且应尽早治疗。证实有淋巴结转移者应积极行腹股沟淋巴结清扫术。     

阻血冷冻治疗阴茎癌

冷冻或阻断血流治疗阴茎癌已有报告,但二者结合治疗尚未见报道。我院从1987年2月至1988年5月采用阻断阴茎血流后冷冻方法治疗阴茎癌30例,临床观察结果发现较单纯冷冻或阻血治疗具有更大的优越性。材料与方法本组患者年龄最小25岁,最大75岁,平均53岁。病史最短1月,最长10年,平均1.3年。按国际抗癌联盟TNM分期,Ⅰ期25例,Ⅱ期3例,Ⅲ期2例,其中鳞癌28例,基底细胞癌、疣状癌各1例。采用SXH型多功能医用冷冻治疗器(现已由     

阴茎癌误诊8例分析

阴茎癌是阴茎最常见的恶性肿瘤，占阴茎肿瘤的90％～97％，因位于体表一般容易确诊，但也有延误诊断的。本文就8例误诊的阴茎癌做一分析。[第一段]     

细针吸取细胞学诊断阴茎转移性直肠腺癌1例并文献复习

目的:提高对阴茎转移性癌的认识及探讨阴茎肿块的诊断方法。方法:对1例阴茎硬结行细针吸取(fine-needle aspiration,FNA)操作及细胞学检查。结果:细胞学涂片见大量高柱状肿瘤细胞,部分细胞可见腺腔样排列,背景中见大量坏死,结合病史考虑阴茎转移性直肠腺癌。结论:阴茎转移性癌少见。其临床主要表现为阴茎硬结、异常勃起等。FNA检查安全、微创、高效、诊断准确,可作为诊断阴茎转移癌的首选方法。     

46例阴茎癌的临床分析及总结——附文献复习

背景与目的:阴茎癌是一种少见的疾病,以鳞状细胞癌为主,主要通过淋巴途径转移.治疗包括局部原发癌切除和对转移淋巴结的处理及放疗、化疗等辅助治疗.本研究旨在探讨阴茎癌合理的治疗方法.方法:对中山大学附属第一医院1996年1月至2005年1月收治的46例阴茎癌患者的临床资料进行回顾性分析,46例患者中鳞状细胞癌44例,Paget病1例,疣状癌1例,对其中23例肿大淋巴结进行活检.结果:39例行阴茎部分切除术,4例行阴茎全切加会阴部尿道造口术治疗,1例Paget病患者行病灶切除植皮术,2例未接受手术治疗.10例淋巴结活检阳性的患者中有9例行腹股沟淋巴结清扫术,5例行同期盆腔淋巴结清扫术.41例患者获定期随访1～10年,1年、2年、5年、10年生存率分别为95.1%、95.1%、82.9%、31.7%.术后病理证实有盆腔淋巴结转移者2例均在2年内死于肺转移.结论:阴茎部分切除术是治疗阴茎癌合理有效的方法,且应尽早手术治疗.淋巴结转移是影响阴茎癌预后的重要因素,有腹股沟淋巴结转移者应早期行淋巴结清扫术治疗,以提高治疗效果.有盆腔淋巴结转移者预后差.     

Verrucous carcinoma in penile lichen sclerosus et atrophicus

A patient presented with a verrucous carcinoma within a lesion of penile lichen sclerosus et atrophicus. We report a case of lichen sclerosus and the specific squamous cell carcinoma variant, verrucous carcinoma, treated by Mohs surgery.     

Verruciform xanthoma of the penis in a young male masquerading as squamous cell carcinoma: Case Report

Verruciform xanthoma (VX) is a relatively rare benign lesion of unknown etiology with a predilection for oral mucosa. Penis is an uncommon location and to date only 17 cases of VX of penis have been reported. The lesion assumes importance as it can be easily mistaken for verrucous carcinoma or squamous cell carcinoma. We present herein a case of penile VX in a 25-year-old man who was referred to our institute with a histopathologic diagnosis of squamous cell carcinoma reported elsewhere. On microscopy the lesion demonstrated florid verruciform hyperplasia of the epidermis with hyperkeratosis, parakeratosis and acanthosis. There was a dense infiltrate of foam cells in the papillary dermis (a hallmark of VX), which were positive for CD68 and negative for S-100 protein. We present this case to highlight the significance of recognizing VX in extra oral location. An awareness of this entity is crucial to prevent misdiagnosis and halt inappropriate therapeutic intervention. Keywords: penis, squamous cell carcinoma, verruciform xanthoma, verrucous carcinoma.     

Verrucous carcinoma arising in ulcerative lichen planus of the soles

Verrucous carcinoma is a low-grade squamous cell carcinoma. Chronic inflammation is an important factor in its pathogenesis. This is the first case of plantar verrucous carcinoma arising in a lesion of ulcerative lichen planus. This paper also lends further support to the successful use of Mohs micrographic surgical technique as the treatment of choice for verrucous carcinoma.     

CLINICOPATHOLOGICAL AND SURGICAL STUDY OF VERRUCOUS CARCINOMA OF PENIS

ＣＬＩＮＩＣＯＰＡＴＨＯＬＯＧＩＣＡＬＡＮＤＳＵＲＧＩＣＡＬＳＴＵＤＹＯＦＶＥＲＲＵＣＯＵＳＣＡＲＣＩＮＯＭＡＯＦＰＥＮＩＳＷａｎｇＸｕｚｈｏｕ；ＺｈａｎｇＺｉｘｕａｎ；ＧａｏＺｈｏｎｇｙｕ；ＬｉａｎｓＳｉｔａｉ；ＴｉａｎＪｉｘｉ王绪洲，张紫萱，高促...     

Verrucous carcinoma of the cervix

An extremely rare case of verrucous carcinoma of the uterine cervix is reported. The most outstanding pathologic feature of this malignant tumor is the benign picture of the proliferative squamous epithelium, with remarkable hyperkeratosis and dyskeratosis. Therefore it is difficult for the pathologist to make an accurate diagnosis on the basis of the biopsy material. Surgery may be best treatment of this special tumor for its behavior of slow invasiveness and rare metastasis.     

Radiotherapy and verrucous carcinoma of the oral cavity. A study of 107 cases.

One hundred and seven cases of oral verrucous carcinoma treated primarily with radiotherapy at Kasturba Hospital, Manipal, India between 1977 and 1987 were analysed concerning location within the oral cavity, clinical extent, and effectiveness of radiotherapy. The most common site was the buccal mucosa followed by the buccogingival sulcus. Only 13.2% of the patients presented with T1 or T2 tumours and 32.7% had clinically negative nodes. Biopsy had to be repeated more than once in 22 patients to get confirmation of invasive carcinoma. The 5-year survival rate was 35% for stage III and 26% for stage IV. The treatment results with radiotherapy were comparable with those for ordinary squamous cell carcinoma of the oral cavity. It is felt that the treatment policy for verrucous carcinoma can be the same as for ordinary squamous cell carcinoma. In order to prevent delay in diagnosis and treatment, proper cooperation between the treating oncologist and the pathologist is essential.     

Proliferative verrucous leukoplakia and its related lesions

Proliferative verrucous leukoplakia (PVL) is a unique type of clinical oral leukoplakia. Enigmatic in etiology, PVL behaves in a far more aggressive fashion than other forms of leukoplakia. Its aggressiveness relates not only to a high recurrence rate, but more so to a very high level of and relentless progression from a localized simple keratosis to extensive oral disease and squamous carcinomas of verrucous, or conventional squamous cell type. Diagnosis is often late in the protracted course of PVL with the disease in an advanced stage when it is especially refractory to treatment. Within the histologic spectrum that is seen in PVL, usually as a function of time, are: (1) verrucous hyperplasia (VH), a histologically defined lesion; (2) varying degrees of dysplasia; and (3) three forms of squamous cell carcinoma: verrucous, conventional and, according to some, papillary squamous cell carcinoma. Each of these are discussed both within and outside the context of PVL. VH is a forerunner of verrucous carcinoma and the transition is so consistent that the hyperplasia, once diagnosed, should be treated like verrucous carcinoma. VH is not only an oral lesion; it can occur in the upper airway (sinonasal tract and larynx) where it is not usually found within a maternal soil of PVL. Papillary squamous cell carcinoma has been a loosely defined neoplasm, more often considered a verrucal type of malignancy. It nonetheless is a distinct clinicopathologic entity, separate from verrucous carcinoma and without a predilection for the oral cavity or an association with PVL.     

Verrucous carcinoma (carcinoma cuniculatum)--clinicopathologic study on 10 cases

10 cases of verrucous carcinoma occurring in different sites were studied clinicopathologically. Clinically, the tumor grew slowly and presented as an ulcerous or cauliflower-like mass. The tumor, existing in the skin, had openings like the sinus tracts on the surface from which foul, grey and greasy material oozed out when pressured. There was no exudation if the lesion grew in the mucosa. Histologically, the tumor was composed of mature and well-differentiated squamous cells showing papilloma-like growth upwards, their epidermal rete showing spheroid expansions downwards. Prickle cell masses invaded into the soft tissue in the deeper layer. In view of the tumors having location either in the skin or mucosa with or without effusion, similar histologic features and biologic behavior, we suggest that the verrucous carcinoma and carcinoma cuniculatum be two different variants of the disease. Finally, its diagnosis, differential diagnosis and treatment are discussed with a review of the literature.     

Pathological and clinical analysis of 102 cases of lip carcinoma

102 cases (103 tumors) of lip carcinoma treated by surgery are analyzed. There were 37 (35.9%) verrucous carcinoma and 66 (64.1%) squamous cell carcinoma which included grade I 29 cases, grade II 21, grade III 14 and grade IV 2. Of the 66 squamous cell carcinomas, six lesions co-existing with verrucous carcinoma were derived from the latter. This fact demonstrated that anaplastic transformation of verrucous carcinoma could occur in patients without radiotherapy. This study suggests that the enlarged neck lymph nodes need not be dissected prophylactically for patients with squamous cell carcinoma grade I and grade II, and with verrucous carcinoma. The management of the cervical nodes still suffices if they enlarge after the primary lesion has been removed. But radical dissection of neck lymph nodes should be performed promptly for patients with squamous cell carcinoma grade III and grade IV.     

Extensive Bowen's disease of the penile shaft treated with fresh tissue Mohs micrographic surgery in two separate operations

Bowen's disease or squamous cell carcinoma in situ is uncommon on the penile shaft. While surgical excision is the treatment of choice, the Mohs micrographic surgical approach ensures microscopically controlled tumor-free margins with preservation of normal tissue. While small- or medium-sized penile excisions heal very well by second intention, large areas of involvement are often grafted to prevent debilitating contractures. We report a case of near circumferential penile Bowen's disease treated by two separate operations that healed by second intention with very good cosmetic and functional results.