Purkayastha Abhishek, Suhag Virender, Taneja Sachin, Husain Azhar
Department of Radiation Oncology, Command Hospital (Southern Command), Pune, Maharashtra, India.
Department of Nuclear Medicine, Command Hospital (Southern Command), Pune, Maharashtra, India.
World J Nucl Med. 2021 Nov 1;20(4):379-381. doi: 10.4103/wjnm.wjnm_74_21. eCollection 2021 Oct-Dec.
Carcinoma penis is a rare malignancy accounting 0.5%-1% of cases in the developed countries with a slightly higher incidence in the developing nations. Slow locoregional progression is characteristic of penile carcinoma (PC) and distant metastases are very uncommon. We hereby report a case of highly aggressive squamous cell PC in a 46-year-old male with fulminant upfront distant dissemination to left supraclavicular lymph nodes (LNs) without involving the inguinal and pelvic nodes detected by whole-body F-fluorodeoxyglucose positron-emission tomography scan. The scan also detected lytic destructive lesion involving the pelvic and adjacent bones with infiltration of skeletal muscles. He was treated with palliative radiotherapy to the wight-bearing sites followed by systemic chemotherapy. A thorough review of literature reveals that our case may be one of the rarest cases ever reported in world literature where an asymptomatic PC presents with upfront supraclavicular LN metastasis bypassing the inguinal, pelvic, and retroperitoneal LN chains.
阴茎癌是一种罕见的恶性肿瘤，在发达国家占所有病例的0.5%-1%，在发展中国家发病率略高。阴茎癌（PC）的特点是局部进展缓慢，远处转移非常少见。我们在此报告一例46岁男性的高侵袭性鳞状细胞阴茎癌病例，通过全身F-氟脱氧葡萄糖正电子发射断层扫描发现，该患者一开始就出现暴发性远处转移至左锁骨上淋巴结，而腹股沟和盆腔淋巴结未受累。扫描还发现盆腔及相邻骨骼有溶骨性破坏病变，伴有骨骼肌浸润。他接受了负重部位的姑息性放疗，随后进行全身化疗。对文献的全面回顾显示，我们的病例可能是世界文献中报道的最罕见病例之一，即无症状阴茎癌一开始就出现锁骨上淋巴结转移，绕过腹股沟、盆腔和腹膜后淋巴结链。
