Penile tumours: a review

Leiomyosarcoma of the Penis: A Case Report and Re-Appraisal

BACKGROUND

Penile leiomyosarcoma arises from smooth muscles, which can be from dartos fascia, erector pili in the skin covering the shaft, or from tunica media of the superficial vessels and cavernosa. We describe presentation, treatment options, and recurrence pattern of this rare malignancy.

CASE PRESENTATION

We present a case of penile leiomyosarcoma in a 70-year-old patient who presented to the urology clinic with 1-year history of a slowly enlarging penile mass associated with phimosis.

CONCLUSIONS

Prognosis of penile LMS is difficult to ascertain because reported cases are rare. Penile leiomyosarcoma can be classified as superficial or deep based on tumor relation to tunica albuginea. Deep tumors (> 3 cm), high-grade lesions, and tumors with involvement of corpora cavernosa, tend to spread locally and metastasize to distant areas and require more radical surgery with or without postoperative radiation therapy. In contrast, superficial lesions can be treated with local excision only.

High-Risk BCC Of the Lower Eyelid in Patient with Presternal Located Cutaneous Melanoma and BCC Of the Shoulder: Melolabial Advancement Flap Combined with Undermining Surgical Approach As Promising Complex One Step Treatment Option!

BACKGROUND:

It is assumed that the occurrence of keratinocyte and melanocytic tumours is multifactorial driven. Certain risk factors such as solar radiation, p53 protein and Melanocortin-1 receptor (MC1R) prove to be common to their development, which at the same time shows that their simultaneous manifestation in the same patients, for example, is quite possible. Such a manifestation could be observed as collision tumours within the same solitary lesion or as a simultaneous occurrence within two completely different lesions that are clearly distinguished from one another.

CASE REPORT:

An 85-year-old patient is presented with three primary cutaneous tumours located in region presternal, infraorbital sinistra and scapularis extra. The lesions were removed during a single surgical session. For the high-risk basal cell carcinoma (BCC) in the lower eyelid, the so-called melolabial advancement flap was applied, and for the tumours located in the other two areas, the undermining surgical approach was applied. The subsequent histological analysis found that the case referred to two keratinocyte tumours (BCC) and one melanocyte tumour (cutaneous melanoma).

CONCLUSIONS:

The patient presented is interesting with regard to 1) the simultaneous presentation of three primaries with different localization (so far not described in the world literature, namely 2 basal cell carcinomas and one melanoma in the same patient concurrently), 2) one of the basal cell tumours belongs to the group of high-risk (according to the localization) and meanwhile advanced BCC (according to the infiltration degree of the underlying tissue-infiltration of the musculature) and 3) their simultaneous successful surgical treatment in a single surgical session under local anaesthesia.

Rare urologic tumors

PURPOSE OF REVIEW

Management of genitourinary malignancy is likely to encompass a large portion of most of the urologist's practice. The challenge for the modern urologist is not only in understanding the management of commonly seen genitourinary malignancies, but also in recognizing unusual variants and their differences in management. This is evermore important as new technologies have refined the ability to identify rare entities. This review presents a brief overview of the various genitourinary malignancy subtypes seen within urology.

RECENT FINDINGS

All major organ subtypes are highlighted along with an overview of the current understanding of their associated malignancies. An update on the current state management paradigms as well as future directions is also outlined.

SUMMARY

After reading this review, the urologist should have a deeper understanding of the breadth of disorders in genitourinary oncology and a clearer approach to the management of these problems. Additionally, ongoing avenues for research are highlighted.

Mucosal Melanoma: a Literature Review

PURPOSE OF REVIEW

Mucosal melanoma is of great interest due to its aggressive behavior and less favorable prognosis. The literature is mainly case reports and case series. Here, we will collect the knowledge on mucosal melanoma from the last decade and review the literature. The main focus is being site-specific clinical features, treatment, and prognosis.

RECENT FINDINGS

The use of immunotherapy gain ground as for others subsets of melanoma. Anti-CTLA-4 and anti-PD-1/ PD-L1 blockade in mucosal melanoma have been evaluated in recent studies. Clinical trials are ongoing. The etiology of mucosal melanomas remains unknown. Head and neck mucosal melanomas are most common. Wide excision surgery is the treatment of choice. The effect of adjuvant therapy on survival remains questionable due to the limited knowledge. Radiotherapy seems to give better local control. The overall five-year survival rate for mucosal melanomas is 0-45%. Recent data indicates that this may be improved by the immunotherapy in the years to come.

Simultaneous Occurrence of Balanoposthitis Circumscripta Plasmacellularis Zoon, Phimosis and in Situ Carcinoma of the Penis: Case Report with An Unusual Ulcerated Polypoid Variant of Zoon's Disease and a Carcinoma in Situ of Reserve Cell Type

BACKGROUND

Zoon's balanitis is a benign disease characterized by an asymptomatic, chronic, solitary, shiny, red-orange plaque of the glans and/ or prepuce. In rare cases of Zoon's disease, penile squamous cell carcinoma developed in the chronic inflammatory lesions.

CASE REPORT

We report on a 68-year-old male patient presenting with phimosis and coexistent Zoon's disease and penile carcinoma in situ treated successfully by circumcision.

CONCLUSION

Coexistence of both lesions in contrast to the development of cancerous lesions within pre-existent Zoon's disease is a very rare observation.

Organ Preservation Surgery for Carcinoma Penis

Carcinoma of the penis is not uncommon in India. A sizeable number of patients do not report to the doctors in fear of mutilation to the organ and hence subsequently end up with advanced disease. Many patients with T1 or T2 disease when carefully selected are amenable to organ-preserving penile procedures including surgery, topical therapy, laser, and radiation therapy. Identification of appropriate patients and institution of these treatments has been noted to produce oncologically comparable results to extirpative surgeries. In this article, we review the criteria to identify patients qualifying for organ-preserving treatments and also review outcomes with a variety of penile-preserving procedures.

A comprehensive characterization of cell cultures and xenografts derived from a human verrucous penile carcinoma

This study aimed to establish and characterize primary cell cultures and xenografts derived from penile carcinoma (PeCa) in order to provide experimental models for cellular processes and efficacy of new treatments. A verrucous squamous cell carcinoma (VSCC) was macrodissected, dissociated, and cultivated in KSFM/DF12 medium. Cell cultures were evaluated at passage 5 (P5) using migration and invasion assays and were serially propagated, in vivo, in BALB/c nude mice until passage 3 (X1-X3). Immunophenotypic characterization of cultures and xenografts was performed. Genomic (CytoScan HD, Affymetrix) and transcriptomic profiles (HTA 2.0 platform, Affymetrix) for VSCC, cell cultures, and xenografts were assessed. P5 cells were able to migrate, invade the Matrigel, and produce tumors in immunodeficient mice, demonstrating their malignant potential. The xenografts unexpectedly presented a sarcomatoid-like carcinoma phenotype. Genomic analysis revealed a high similarity between the VSCC and tumor-derived xenograft, confirming its xenograft origin. Interestingly, a subpopulation of P5 cells presented stem cell-related markers (CD44(+)CD24(-) and ALDH1(high)) and sphere-forming capacity, suggesting their potential xenograft origin. Cell cultures and xenografts retained the genomic alterations present in the parental tumor. Compared to VSCC, differentially expressed transcripts detected in all experimental conditions were associated with cellular morphology, movement, and metabolism and organization pathways. Malignant cell cultures and xenografts derived from a verrucous penile carcinoma were established and fully characterized. Nevertheless, xenograft PeCa models must be used with caution, taking into consideration the selection of specific cell populations and anatomical sites for cell/tumor implantation.