title: [Diagnosis and treatment of penile verrucous carcinoma: a report of 4 cases].
abstract: OBJECTIVE
  To explore the diagnosis and treatment of penile verrucous carcinoma.
  
  
  METHODS
  The clinical and pathological data of 4 patients with penile verrucous carcinoma were analyzed.
  
  
  RESULTS
  The patients ranged in age from 42 to 76 years (average 52). All the tumors showed exophytic papillary lesions, the biggest being 2.1 to 5.8 cm in diameter. The lesions were confined to the glans penis in two cases and invaded the shafts in the other 2 (1 accompanied by syphilis). One patient, whose tumor was small (1.4 cm in diameter) and confined to the glans penis, underwent glandectomy. One with a larger tumor confined to the glans penis and the other 2 with the shafts involved underwent partial penectomy, including the one accompanied by syphilis, who underwent the operation after treated by Benzathine benzylpenicillin. Histopathological examination of the specimens showed that the tumor cells were mostly well-differentiated and the surgical margins were tumor free in all the 4 cases. HE stain was performed in all the specimens. Microscopic examination revealed papillomatosis and hyperkeratosis of the epithelium, with bulbous projections into the lamina propria consisting of well-differentiated squamous epithelial cells. Marked invasion of the stroma by lymphocytes was noted. Follow-up ranged from 3 to 7 years (average 4.6), revealing no recurrence. The result of the rapid plasma regain (RPR) test was negative but that of the Treponema pallidum passive-particle-agglutination (TPPA) test remained positive in the blood of the patient accompanied by syphilis after treatment.
  
  
  CONCLUSIONS
  Verrucous carcinoma of the penis is characterized by low malignant potential and locally aggressive nature. It seldom develops metastasis to regional lymphonodes or distant areas. Glandectomy or partial penectomy can be chosen for its treatment, with favorable prognosis.
authors.affiliation: Department of Urology, Affiliated Hospital of Qingdao University Medical College, Qingdao, Shandong 266003, China. wangzhenlin@hotmail.com
authors.forename: Zhen-lin
authors.initials: ZL
authors.lastname: Wang
authors.forename: Mei-rong
authors.initials: MR
authors.lastname: Ou
authors.forename: Xian-lu
authors.initials: XL
authors.lastname: Sun
authors.forename: Xiao-fang
authors.initials: XF
authors.lastname: Wang
authors.forename: Jin-feng
authors.initials: JF
authors.lastname: Zhang
authors.forename: Li-jiang
authors.initials: LJ
authors.lastname: Sun
authors.forename: Peng
authors.initials: P
authors.lastname: Zhao
authors.forename: Xiang-rui
authors.initials: XR
authors.lastname: Ji
mesh_terms: D000368:Aged; D018289:Carcinoma, Verrucous / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010412:Penile Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery