A novel combination of double primary malignancies: penile carcinoma and glioblastoma. A series of two cases.

AIM

Penile squamous cell carcinoma (pSCC) and glioblastoma (GB) are rare malignant tumors that develop especially in the elderly. The aim of our paper is to present two patients diagnosed and treated for a cerebral GB developed after a prior pSCC and to discuss the possible mechanism of their association.

PATIENTS, MATERIALS, AND METHODS: The medical records of 632 patients admitted for a GB in the Department of Neurosurgery, "Prof. Dr. Nicolae Oblu" Emergency Clinical Hospital, Iaşi, Romania, between April 2010 and April 2018, were retrospectively searched for those having a prior histological proven cancer. The review found only two patients (0.31% of all cases with GB) and their demographics, clinical presentation, medical history, treatment and pathological diagnosis were reviewed and discussed.

RESULTS

Both patients were 65-year-old on their admission in the Department of Neurosurgery. Their prior penile tumors were both located at the penis glans. In both cases, the histopathological exam revealed a penile keratinized squamous cell carcinoma stage T1aN0M0 at the moment of their first urological diagnosis. At the time of the neurosurgical evaluation, brain radiological investigations demonstrated right frontal cystic neoformation in the first case, and a right frontal-parietal solid, expansive lesion for the second patient. The patients underwent subtotal surgical excision of their brain masses. The histopathological exam revealed in both cases a World Health Organization (WHO) grade IV GB.

CONCLUSIONS

This is the first clinical report of a new association between pSCC and subsequent development of GB in a series of two patients. Both our patients developed a prior pSCC without any lymph node and distant metastasis at their first diagnosis and this situation reinforces the idea that this type of cancer has a good prognosis and that the patient can develop a second cancer during his post-penectomy life, probably due to a genetic predisposition, post-therapeutic effects, life style factors (smoke effects), sporadic association, or due to the common embryological origin of the nervous and skin tissues.