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[一例源自直肠的阴茎继发性肿瘤伴恶性阴茎异常勃起的临床病例]

[A clinical case of secondary tumor of the penis from the rectum, with malignant priapism].

作者信息

Okumura S, Hirasawa S, Yui Y, Yoshida K, Nishimura T, Akimoto M

出版信息

Hinyokika Kiyo. 1984 Feb;30(2):205-15.

PMID:6741757
Abstract

We report a clinical case of carcinoma of the rectum. A 45-year-old patient had undergone resection of the rectum and proctostomy 22 months ago. Carcinoma caused metastasis to the corpora cavernosa of the penis in this patient, and caused local recurrence of the carcinoma of the rectum, pulmonary metastasis and malignant priapism. A statistical analysis of 62 cases of secondary tumor of the penis in Japan was also made. The present clinical case was the 62nd case of secondary tumor of the penis in Japan, and the 4th case of secondary penile tumor from the rectum. The primary foci of the secondary tumor of the penis are mostly in the urinary bladder and the prostate, followed by the rectum, kidney, pelvis of the kidney and the ureter. Primary sites in the urogenital organs were found in 82.3% and in the neighboring organs in 85.2%. As the route of metastasis of the secondary tumor of the penis, arterial blood, retrovenous, retro-lymph and direct infiltrating metastasis may be possible. Secondary tumor of the penis is mostly found in aged persons, and the major symptoms may be penile nodule and mass, malignant priapism, penile pain and tenderness, and difficulty in urination and retention of urine. Regardless of the length to metastasis and difference in the treatment of the metastatic focus, the secondary tumor of the penis is poor in prognosis, and survival period may be up to 7 months. From the findings of post-mortem examination, secondary tumor of the penis should be regarded as a secondary sign due to recurrence of the primary tumor or presence of metastasis in other organs, and careless surgical operation should be avoided.

摘要

我们报告一例直肠癌病例。一名45岁患者在22个月前接受了直肠切除术及直肠造口术。该患者的癌症转移至阴茎海绵体,并导致直肠癌局部复发、肺转移及阴茎异常勃起。我们还对日本62例阴茎继发性肿瘤病例进行了统计分析。本临床病例是日本第62例阴茎继发性肿瘤,也是第4例源自直肠的阴茎继发性肿瘤。阴茎继发性肿瘤的原发灶大多位于膀胱和前列腺,其次是直肠、肾脏、肾盂和输尿管。泌尿生殖器官的原发部位占82.3%,邻近器官的原发部位占85.2%。作为阴茎继发性肿瘤的转移途径,动脉血行转移、静脉逆行转移、淋巴逆行转移及直接浸润转移均有可能。阴茎继发性肿瘤多见于老年人,主要症状可能为阴茎结节及肿块、阴茎异常勃起、阴茎疼痛及压痛、排尿困难和尿潴留。无论转移的程度及转移灶治疗方法的差异如何,阴茎继发性肿瘤的预后均较差,生存期可能长达7个月。根据尸检结果,阴茎继发性肿瘤应被视为原发肿瘤复发或其他器官存在转移的继发征象,应避免草率的手术操作。

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