Wang Zhen-lin, Ou Mei-rong, Sun Xian-lu, Wang Xiao-fang, Zhang Jin-feng, Sun Li-jiang, Zhao Peng, Ji Xiang-rui
Department of Urology, Affiliated Hospital of Qingdao University Medical College, Qingdao, Shandong 266003, China.
Zhonghua Nan Ke Xue. 2007 Jun;13(6):527-30.
To explore the diagnosis and treatment of penile verrucous carcinoma.
The clinical and pathological data of 4 patients with penile verrucous carcinoma were analyzed.
The patients ranged in age from 42 to 76 years (average 52). All the tumors showed exophytic papillary lesions, the biggest being 2.1 to 5.8 cm in diameter. The lesions were confined to the glans penis in two cases and invaded the shafts in the other 2 (1 accompanied by syphilis). One patient, whose tumor was small (1.4 cm in diameter) and confined to the glans penis, underwent glandectomy. One with a larger tumor confined to the glans penis and the other 2 with the shafts involved underwent partial penectomy, including the one accompanied by syphilis, who underwent the operation after treated by Benzathine benzylpenicillin. Histopathological examination of the specimens showed that the tumor cells were mostly well-differentiated and the surgical margins were tumor free in all the 4 cases. HE stain was performed in all the specimens. Microscopic examination revealed papillomatosis and hyperkeratosis of the epithelium, with bulbous projections into the lamina propria consisting of well-differentiated squamous epithelial cells. Marked invasion of the stroma by lymphocytes was noted. Follow-up ranged from 3 to 7 years (average 4.6), revealing no recurrence. The result of the rapid plasma regain (RPR) test was negative but that of the Treponema pallidum passive-particle-agglutination (TPPA) test remained positive in the blood of the patient accompanied by syphilis after treatment.
Verrucous carcinoma of the penis is characterized by low malignant potential and locally aggressive nature. It seldom develops metastasis to regional lymphonodes or distant areas. Glandectomy or partial penectomy can be chosen for its treatment, with favorable prognosis.
探讨阴茎疣状癌的诊断与治疗。
分析4例阴茎疣状癌患者的临床及病理资料。
患者年龄42～76岁（平均52岁）。所有肿瘤均表现为外生性乳头状病变，最大直径2.1～5.8 cm。2例病变局限于阴茎头，另2例侵犯阴茎体（1例伴有梅毒）。1例肿瘤较小（直径1.4 cm）且局限于阴茎头的患者行阴茎头切除术。1例肿瘤较大但局限于阴茎头的患者及另2例阴茎体受累的患者行阴茎部分切除术，其中伴有梅毒的患者在接受苄星青霉素治疗后进行手术。标本的组织病理学检查显示肿瘤细胞大多分化良好，4例手术切缘均无肿瘤残留。所有标本均行HE染色。显微镜检查显示上皮乳头瘤病和角化过度，向固有层呈球状突起，由分化良好的鳞状上皮细胞组成。可见淋巴细胞明显浸润间质。随访3～7年（平均4.6年），无复发。梅毒患者治疗后血液快速血浆反应素环状卡片试验（RPR）结果为阴性，但梅毒螺旋体颗粒凝集试验（TPPA）结果仍为阳性。
阴茎疣状癌具有恶性潜能低和局部侵袭性的特点。很少发生区域淋巴结或远处转移。可选择阴茎头切除术或阴茎部分切除术进行治疗，预后良好。
