Kubota Yasuaki, Nakano Masahiro, Nagai Shingo, Matsuoka Kae, Arakawa Hirotaka, Horie Kengo, Deguchi Takashi, Kato Hisakazu
The Department of Urology, TOYOTA Memorial Hospital.
The Department of Urology, Gifu University School of Medicine.
Hinyokika Kiyo. 2015 Jan;61(1):33-7.
Carcinoma of the penis is rare, and the prognosis of penile cancer with inguinal metastases is extremely poor. Standard chemotherapy for advanced penile cancer has not been established because of its rarity. A case of penile cancer with inguinal metastases that responded well to neoadjuvant chemotherapy with paclitaxel, ifosfamide and cisplatin (TIP) is described. A 55-year-old Japanese male visited our hospital for a penile tumor and fixed, 4 cm, right inguinal lymph nodes. Computed tomography and 18F-FDG-PET imaging showed not only right but also left inguinal lymphadenopathy. Penile cancer (clinical stage T3N3M0, 7th edition TNM classification) was diagnosed, and partial penectomy and right inguinal biopsy were performed. The pathological examination revealed squamous cell carcinoma of the penis with right inguinal lymph node metastasis. The inguinal metastases were judged to be unsuitable for radical resection ; and, paclitaxel 60 mg/m2 (day 1), ifosfamide 1,200 mg/m2 (days 1-3), and cisplatin 60 mg/m2 (days 1-3) were given at 3-week intervals as neoadjuvant chemotherapy. After 4 courses of chemotherapy, the inguinal metastases were markedly reduced. He had neutropenia (grade 3) during each course and peripheral neuropathy after 2 courses, but there were no severe complications. The patient underwent bilateral inguinal and pelvic lymphadenectomy after neoadjuvant chemotherapy. Pathological examination revealed no viable cells in the resected specimens. The patient remains alive and well with no evidence of recurrence 8 months after this radical treatment. TIP chemotherapy appears to be effective for advanced penile cancer.
阴茎癌较为罕见，伴有腹股沟转移的阴茎癌预后极差。由于其罕见性，晚期阴茎癌的标准化疗方案尚未确立。本文描述了一例伴有腹股沟转移的阴茎癌患者，其对紫杉醇、异环磷酰胺和顺铂（TIP）新辅助化疗反应良好。一名55岁的日本男性因阴茎肿物及右侧腹股沟淋巴结固定、直径4cm而就诊于我院。计算机断层扫描和18F-FDG-PET成像显示不仅右侧而且左侧腹股沟均有淋巴结肿大。诊断为阴茎癌（临床分期T3N3M0，第7版TNM分类），并行阴茎部分切除术及右侧腹股沟活检。病理检查显示阴茎鳞状细胞癌伴右侧腹股沟淋巴结转移。腹股沟转移灶被判定不宜行根治性切除；于是，以3周为间隔给予紫杉醇60mg/m2（第1天）、异环磷酰胺1200mg/m2（第1 - 3天）和顺铂60mg/m2（第1 - 3天）进行新辅助化疗。4个疗程化疗后，腹股沟转移灶明显缩小。每个疗程期间他均出现中性粒细胞减少（3级），2个疗程后出现周围神经病变，但无严重并发症。新辅助化疗后患者接受了双侧腹股沟及盆腔淋巴结清扫术。病理检查显示切除标本中无存活细胞。根治性治疗8个月后，患者仍存活且状况良好，无复发迹象。TIP化疗似乎对晚期阴茎癌有效。
