阴茎疣状癌诊治体会(附7例报告)

Diagnosis and treatment of penile verrucous carcinoma(a report of 7 cases)

目的探讨阴茎疣状癌的诊断和治疗方法。方法回顾性分析7例阴茎疣状癌患者的临床、病理资料及随访结果。结果患者年龄45～72岁,平均56岁。肿瘤均呈菜花状、外生型生长,最大直径1.6～6.3 cm。该7例病变几乎均局限在阴茎头部包皮及龟头;术前均行活检;治疗以阴茎部分切除或肿块切除;术后病理报告高分化鳞癌,切缘均阴性;术后抗炎+抗病毒治疗,未做放、化疗;随访该7例至目前尚无复发及转移。结论阴茎疣状癌分化良好,以局部侵袭性生长为主,很少有淋巴结或远处转移,活检方法不当易于误诊,治疗方法采用阴茎部分切除或肿块切除,患者预后较好,但术后应严密观察局部复发。

[Objective] To explore the diagnosis and treatment of penile verrueous carcinoma. [Method] The clinical, pathological, and followed data of 7 patients with penile verrueous carcinoma were analyzed retrospectively. [ Results ] The patients＇ age ranged from 45 to 72 years （average 56）. All the tumors showed exophytic cauliflower in shape, and the max diameter ranged from 1.6 to 6.3 cm. The lesions of all the tumors were confined to the glans and skin of penis. All the tumors were biopsied before operation. The cases were treated with partial peneetomy or local mass resection. Histopathologieal examination of the speeimens showed that the tumor cells were mostly well- differentiated squamous cell carcinoma and the surgieal margins showed negative in all the 7 eases. No cases were given chemotherapy or radiation therapy after operation. Postoperative follow-up of 8 months to 7 years showed no recurrence and metastasis in all the cases. [Conclusion] Penile verrucous eareinoma is well-differentiated and characterized by low malignant potential and locally aggressive nature. It seldom develops metastasis to regional lymphonodes or distant areas. Misdiagnosis can be easy to be made by incorrect biopsy. Partial peneetomy or local mass resection can be chosen for its treatment. Excellent treatment outcomes can be gained by surgery alone and the patients should be carefully followed for recurrence.