Hao Yichang, Xia Li, Lu Min, Liu Chenhong, Zhang Fan, Yan Ye, Huang Yi, Zhang Shudong
Department of Urology, Peking University Third Hospital, Beijing, China.
Department of Pathology, Peking University Third Hospital, Beijing, China.
Front Surg. 2023 Jan 9;9:1068935. doi: 10.3389/fsurg.2022.1068935. eCollection 2022.
Leiomyosarcoma (LMS) is a malignant spindle-cell mesenchymal tumor originating from the smooth muscle cells, which mostly affects soft tissues and abdominopelvic organs over extremities. Primary LMS of the penis is a relatively uncommon mesenchymal tissue disease and a poorly understood condition.
A 69-year-old man presented with a growing, painless mass protruding from the penis. The irregularly lobulated lump was roughly 3 cm × 2.5 cm, with a smooth surface, tough texture, distinct boundary, and no tenderness. It was determined to be a penile tumor during the preoperative radiological evaluation. The patient underwent resection of the penile mass, followed by extended resection in the second operation. The diagnosis of LMS was verified by pathological examination. During a 20-month follow-up, the patient made a smooth recovery and remained disease-free.
An immunohistochemical examination is essential for rendering this rare diagnosis. Radical excision of tumor lesions with negative cut margins is guaranteed to be the best treatment for primary penile LMS. Close follow-up should be provided due to the high rate of local recurrence.
平滑肌肉瘤（LMS）是一种起源于平滑肌细胞的恶性梭形细胞间叶组织肿瘤，主要累及软组织及四肢的腹盆腔器官。阴茎原发性LMS是一种相对罕见的间叶组织疾病，目前对此病了解甚少。
一名69岁男性患者，阴茎出现一个逐渐增大的无痛性肿物。该肿物呈不规则分叶状，大小约为3 cm×2.5 cm，表面光滑，质地坚韧，边界清晰，无压痛。术前影像学评估确定为阴茎肿瘤。患者接受了阴茎肿物切除术，第二次手术进行了扩大切除。病理检查证实为LMS。在20个月的随访期间，患者恢复顺利，无疾病复发。
免疫组化检查对于做出这种罕见诊断至关重要。保证肿瘤病变切缘阴性的根治性切除是原发性阴茎LMS的最佳治疗方法。由于局部复发率高，应进行密切随访。
