Warren Alpert Medical School of Brown University, Providence, RI, U.S.A.
Department of Pathology, Kaiser Permanente Sacramento Medical Center, Sacramento, CA, U.S.A.
Anticancer Res. 2022 Jul;42(7):3601-3605. doi: 10.21873/anticanres.15847.
The synchronous diagnoses of three primary malignancies in a patient is rare and represents a difficult treatment challenge. We report a rare case of an 81-year-old male with synchronous triple urogenital cancers including penile squamous cell carcinoma, bladder papillary urothelial carcinoma, and prostate adenocarcinoma.
The patients presented with a penile lesion with blood draining through the foreskin. Further examination with cystoscopy during the biopsy procedure revealed a 1.5-cm tumor along the left lateral bladder wall and a firm prostate in bilateral lobes. Diagnosis of penile squamous cell carcinoma was confirmed by biopsies of the penile lesions and glans as confirmed by cystoscopy and histological evaluation of the tissue obtained by transurethral resection of the bladder. Biopsies of the prostatic urethra confirmed a diagnosis of prostate adenocarcinoma. All biopsies were performed in a single procedure. Pathology findings revealed moderately differentiated squamous cell carcinoma (p16+) invading the lamina propria of the glans penis, noninvasive low-grade papillary urothelial carcinoma of the bladder, and high-grade prostatic adenocarcinoma (Gleason score 5+5=10) within the prostatic stroma.
Review of the English literature through PubMed search suggests that this specific combination of synchronous triple urogenital cancer is the first documented case of its kind. Incidence, diagnosis, and treatment for the combination of these cancer types are discussed with consideration for concurrent management of three primary cancers.
在一名患者中同时诊断出三种原发性恶性肿瘤较为罕见，这代表着治疗上的巨大挑战。我们报告了一例罕见的 81 岁男性患者，其同时患有三种泌尿系统恶性肿瘤，包括阴茎鳞状细胞癌、膀胱乳头状尿路上皮癌和前列腺腺癌。
患者因阴茎病变伴包皮下渗血就诊。在活检过程中进行的膀胱镜检查进一步发现左外侧膀胱壁有一个 1.5 厘米的肿瘤，双侧叶前列腺质地坚硬。阴茎鳞状细胞癌的诊断通过阴茎病变和龟头的活检得到确认，这是通过膀胱镜和经尿道前列腺切除术获得的组织的组织学评估证实的。前列腺尿道活检证实了前列腺腺癌的诊断。所有活检均在一次手术中进行。病理学检查结果显示，阴茎龟头固有层中度分化的鳞状细胞癌（p16+）浸润、膀胱非浸润性低级别乳头状尿路上皮癌和前列腺基质内高级别前列腺腺癌（Gleason 评分 5+5=10）。
通过 PubMed 检索对英文文献的回顾表明，这种特定的同步三重泌尿系统恶性肿瘤组合是首例有记录的病例。讨论了这种癌症类型组合的发病率、诊断和治疗，并考虑了三种原发性癌症的同时治疗。
