Chaux Alcides, Amin Mahul, Cubilla Antonio L, Young Robert H
Instituto de Patología e Investigación, Asunción, Paraguay.
Int J Surg Pathol. 2011 Oct;19(5):597-606. doi: 10.1177/1066896909350468. Epub 2010 Jan 14.
This study presents clinicopathologic and outcome features of 17 patients with metastatic tumor to the penis. Primary sites and histological types were as follows: 6 urothelial carcinomas of urinary bladder, 4 prostatic carcinomas (2 adenocarcinomas and 2 adenosquamous carcinomas), 2 colorectal adenocarcinomas, 2 pulmonary carcinomas (1 squamous cell carcinoma and 1 small cell carcinoma), 1 squamous cell carcinoma of base of the tongue, 1 cutaneous malignant melanoma, and 1 acute myeloid leukemia. Literature review revealed similar distribution of organ sites in 437 cases. Most of our tumors were metachronous. Interval between primary and penile metastasis ranged from 3 to 60 months (mean 16 months). Most of the patients presented with a penile mass. Priapism was observed in 4 patients. The shaft was the commonest anatomical site involved (12 cases). Tumor emboli were usually found in the erectile tissues (14 cases), mainly corpora cavernosa. A total of 14 patients died of disseminated disease. Time interval between primary tumor and penile metastasis ranged from 3 to 60 months (mean 19 months) and between diagnosis of penile metastasis and death ranged from 0.25 to 18 months (mean 6 months), significantly shorter (P = .0058). Patients presented a median survival of 18 months from primary treatment and 5 months after diagnosis of penile metastasis. None of the patients who died of disseminated cancer lived more than 18 months after pathological diagnosis. Clinical evidence of penile involvement in a patient with a known malignancy is an ominous sign and should alert the clinicians to the dismal prognosis.
本研究呈现了17例阴茎转移性肿瘤患者的临床病理特征及预后情况。原发部位和组织学类型如下:6例膀胱尿路上皮癌,4例前列腺癌(2例腺癌和2例腺鳞癌),2例结直肠腺癌,2例肺癌(1例鳞状细胞癌和1例小细胞癌),1例舌根鳞状细胞癌,1例皮肤恶性黑色素瘤,以及1例急性髓系白血病。文献回顾显示,在437例病例中器官部位分布相似。我们的大多数肿瘤为异时性。原发肿瘤与阴茎转移之间的间隔时间为3至60个月(平均16个月)。大多数患者表现为阴茎肿物。4例患者出现阴茎异常勃起。阴茎体是最常受累的解剖部位(12例)。肿瘤栓子通常见于勃起组织(14例),主要是海绵体。共有14例患者死于播散性疾病。原发肿瘤与阴茎转移之间的时间间隔为3至60个月(平均19个月),阴茎转移诊断与死亡之间的时间间隔为0.25至18个月(平均6个月),明显更短(P = 0.0058)。患者从初始治疗开始的中位生存期为18个月,从阴茎转移诊断后为5个月。死于播散性癌症的患者在病理诊断后均未存活超过18个月。已知患有恶性肿瘤的患者出现阴茎受累的临床证据是一个不祥之兆,应提醒临床医生注意其预后不佳。