[Diagnosis and treatment of penile verrucous carcinoma: a report of 4 cases].
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.
Wang
Zhen-lin
ZL
Department of Urology, Affiliated Hospital of Qingdao University Medical College, Qingdao, Shandong 266003, China. wangzhenlin@hotmail.com
Ou
Mei-rong
MR
Sun
Xian-lu
XL
Wang
Xiao-fang
XF
Zhang
Jin-feng
JF
Sun
Li-jiang
LJ
Zhao
Peng
P
Ji
Xiang-rui
XR
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