The curious case of a penile cancer’s local recurrence – A case report
DOI: 10.22591/magyurol.2024.4.kovacspt.194
Authors:
Kovács Petra Terézia dr.1, Vargha Judit dr.1, Kocsmár Ildikó dr.1,
Szarvas Tibor dr.1,2, Riesz Péter dr.1
1Semmelweis Egyetem ÁOK, Urológiai Klinika, Budapest (igazgató: Nyirády Péter dr.)
2Duisburg-Esseni Egyetem, Urológiai Klinika, Essen
Summary
Objective: Penile cancer is a rare malignancy often diagnosed at an advanced stage, resulting in low treatment success rates. We present a case of a patient with penile cancer who was treated at the Department of Urology, Semmelweis University since 2012.
Case report: A 68-year-old male presented to our clinic in 2012 with a 15 millimetre lesion on the glans. Excision confirmed a T1aG1 planocellular carcinoma with negative surgical margins. The patient did not return for follow-up control for 3 years. In 2015, he noticed a new lesion on the glans, with no palpable inguinal lymph nodes. Circumcision and glans resection were performed, with histological evaluation, which confirmed the same diagnosis with tumour-free surgical margins. The institutional tumourboard recommended a close follow-up without additional interventions. In 2017, neoplastic infiltration into the urethral meatus was detected during a control examination. Computed tomography (CT) and magnetic resonance imaging (MRI) in 2015 and 2017 were negative for metastasis. In 2018, the patient underwent transvesical adenomectomy for bladder stone and retention, but follow-up was not conducted until 2021 when a cauliflower lesion was detected at the urethral meatus. Histological evaluation after surgical excision confirmed a T1aG1 planocellular carcinoma again, with no lymph node or distant metastasis. The latest control examination in 2022 had a negative result, the patient died later that year due to a heart attack.
Conclusion: Our case report demonstrates that the histological features of penile cancer may remain unchanged over 10 years, despite poor compliance. Accordingly, this case underscores the importance of aiming for organ-sparing surgery while also considering oncological goals and guidelines to ensure the optimal quality of life for the patient.