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- Title
Total glans resurfacing for "in situ" squamous cell carcinoma of the penis.
- Authors
Gingu, C.; Olaru, V.; Dick, A.; Baston, C.; Crăsneanu, M.; Pătrăşcoiu, S.; Surcel, C.; Himedan, O.; Domnişor, L.; Sinescu, I.
- Abstract
Introduction and objectives: The true incidence of premalignant lesions or low stage / grade penile tumors is often underestimated, these problems being treated by dermatologists. When topic treatments fail, the cases are referred to the urologist. Surgery with its mutilating consequences can be considered an overtreatment, therefore conservative techniques like glans resurfacing must be taken into account. The aim of this paper is to present the case of a 67 year old male with squamous cell carcinoma who underwent glans resurfacing. Materials and Methods: We present the case of a 67-year-old male with superficial penile lesions and no notable co-morbidities who was diagnosed after a glans biopsy with Queyerat eritroplasia. After diagnosis, the patient underwent topical treatment with 5-fluorouracil (5-FU). Due to bleeding occurring from the lesion after sexual contact, the patient repeated the biopsy 6 months later. The result was "in situ" squamous cell carcinoma. After a full body CT scan (recommended by the dermatologist), that turned out uneventful, the patient was referred to out department. We decided to perform glans skin excision with resurfacing. After we placed the urinary catheter, the glans skin was excised and multiple biopsies were taken from the spongiosal tissue. The circumference and length of the remained defect was measured. Then we harvested a full thickness skin graft from the abdominal left flank wall using a geometric pattern. The donor site defect was closed and the harvested skin was quilted over the spongiosum using 4/0 Vicryl sutures. We used a tie over dressing at the end of the surgery. Results: The pathological report was: "in situ" squamous cell carcinoma. The biopsies from the remaining spongiosal tissue turned out negative for cancer. The urinary catheter was suppressed the second day after surgery and the patient was discharged in the third day. The dressing was removed in the 7th day postoperatory. At the 3-month follow- up, the cosmetic penile aspect was excellent and the patient presented good functional results, having returned to a full sexual activity. Conclusions: Primary premalignant glans lesions and "in situ" SCC can be safely treated using TGR even for patients with failed topical treatments, resulting in an optimal aesthetic, functional and psychological outcome as well as an improved quality of life. A close follow-up in necessary in order to rapidly diagnose possible recurrences.
- Subjects
CANCER treatment; SQUAMOUS cell carcinoma; FLUOROURACIL; MALE reproductive organ diseases; URINARY catheterization; THERAPEUTICS
- Publication
Romanian Journal of Urology, 2014, Vol 13, Issue 3, p53
- ISSN
1223-0650
- Publication type
Case Study