A PROSPECTIVE STUDY ON CLINICAL PRESENTATION AND MANAGEMENT PROTOCOLS OF CARCINOMA PENIS IN TERTIARY CARE CENTRE

INTRODUCTION:Carcinoma of the penis is a malignancy with a wide range of clinical and pathological presentations. It constitutes a major substantial health concern in many developing countries including India. Proper evaluation of both the primary lesion and lymph nodes is critical because nodal involvement is the most important factor for survival. This study was undertaken to [1,2,3] determine incidence with age, religion, and socioeconomic status and to study risk factors and its management . METHODS:A descriptive study was conducted among 30 patients with proven carcinoma penis for a period of 2 years. RESULTS: In my study the maximum incidence was found to be in the age group of 50 to 70. All cases were Hindus and Muslims were free of disease may be due to early circumcision. In my study 86.6% of the patients associated with carcinoma penis were smokers. The commonest symptom at presentation was proliferative growth (76%). The most common site of origin was the Glans penis. The average time interval between onset of symptoms and seeking medical advice is 7 Months. The most common surgery performed was partial penectomy (73.3%) and a majority of the biopsy report showed SCC. Moderately and poorly differentiated tumors had a very strong association with nodal involvement. CONCLUSION: Carcinoma penis can be avoided by better penile hygiene and circumcision. It is a curable disease, if detected early and treated properly. The surgery is the mainstay of treatment. Creating awareness in public is the only way to reduce mortality and morbidity due to the carcinoma of the penis.

Gracilis Muscle and Myocutaneous Flap

Gracilis muscle is type II muscle flap. Total 16 cases were operated on with Gracilis muscle or myocutaneous flap. Group A – loss of scrotal skin following Fournier’s gangrene. Group B - Traumatic avulsion of the scrotal skin, Group C – Anal incontinence following Surgical repair of imperforate anus. Group D – Carcinoma penis operated for total amputation of the penis. Amputation of the penis. All the patients from Group A did well except for necrosis at the margin of the flaps in two patients. In Group B patient did well without any complication in Group C Three out of five patients did well. Two patients were still incontinent. In Group D, the first patient had a good flap for seven days. Later there was discolouration and on a ninth day, there was complete discolouration of the skin pedicle. Debridement was done, the muscle underneath was viable. A split-thickness skin graft was applied. The graft takes up was good. Within 10 days the muscle contracted too much an extent that the size of the phallus became almost nil.

CARCINOMA PROSTATE WITH CARCINOMA PENIS: RARE CASE OF DUAL PRIMARY UROLOGICAL MALIGNANCY

Synchronous malignancies are an uncommon finding in urology. A penile lesion in a patient of carcinoma prostate is an uncommon is generally a metastasis with incidence of <0.1%. Here we present a case of synchronous primary urological malignancies of squamous cell carcinoma of penis and adenocarcinoma prostate. Synchronous malignancies should be considered on an individual basis and therapeutic choice should aim to provide minimal possible morbidity with maximum efficacy without compromising oncological outcomes.

Occult carcinoma penis presenting as malignant pleural effusion

A case of left sided malignant pleural effusion is described in a 41-year-old male, his initial workup for primary site of malignancy was unknown but later found to have hidden squamous cell carcinoma of penis which is one of the rarest site of malignancy that metastasise to pleura. Penile carcinoma manifesting with pleural metastasis and pleural effusion as initial presentation has not been reported previously.