阴茎疣状癌的临床诊断和治疗

The clinical diagnosis and treatment of penile verrucous carcinoma

目的探讨阴茎疣状癌的诊断和治疗。方法回顾性分析6例阴茎疣状癌患者的诊治资料。患者平均年龄45岁。肿瘤均为菜花状、外生型,最大径2～6cm,局限于阴茎头4例,侵犯至冠状沟近侧2例。3例在术前经病理活检确诊,另3例为术后病检证实。2例肿瘤侵犯冠状沟近侧者和2例位于阴茎头肿瘤较大者行阴茎部分切除术,1例局限于阴茎头与冠状沟之间者给予包皮环切术,1例局限于阴茎头者行肿瘤局部切除术。结果病理检查见肿瘤细胞分化好,标本切缘均阴性。6例术后随访2～4年,无肿瘤复发或转移。结论6例阴茎疣状癌以局部侵袭性生长为主,未发生区域性淋巴结转移或远处转移,选择手术方式合理,预后良好。

Objective To explore the diagnosis and treatment of penile verrucous carcinoma. Methods Six cases of verrucous carcinoma were reviewed. The clinical data of those cases （mean age,45 years） were analyzed retrospectively. All the tumors showed exophytic papillary lesions, and diameter ranged from 2-6 em in the greatest dimension. Tumors of 4 cases confirmed in glans, and those of 2 cases invaded to the shaft of penis. The diagnosis was confirmed by biopsy in 3 cases while others by pathology after surgery. Four patients were performed partial penectomy and 1 patient cir- cumcision,and the other by local resection. Results Cells for the verrucous carcinoma were mostly well differentiated. Tumors free surgical margins were achieved in all cases. During the follow-up of 2-4 years,all patients were disease free and had neither recurrence nor metastasis. 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. Excellent treatment outcomes can be gained by proper surgery.