Penile cancer is uncommon among other urological malignancies, squamous cell carcinoma being the most common type of penile cancer. This case report presents a patient with rapidly progressive angiosarcoma who underwent penile amputation.

• Klíčová slova
• Angiosarcoma, penile amputation, penile cancer, sarcoma,
• MeSH
• amputace MeSH
• lidé MeSH
• nádory měkkých tkání * MeSH
• nádory penisu * patologie   chirurgie   MeSH
• penis patologie   chirurgie   MeSH
• sarkom * chirurgie   MeSH
• spinocelulární karcinom * patologie   chirurgie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Penile carcinoma is an uncommon but potentially mutilating disease with a heterogeneous etiology. We present a case in which a man died due to severe blood loss from an amputated penis. It was initially regarded as a violent death with an external cause. Autopsy found irregular defects with smooth edges in the external genital area and on both sides of the groin, with yellowish-gray callus-like structures and dried blood at the base of where the penis would have been located. Histological examination revealed the presence of squamous cell carcinoma with signs of keratinization. Subsequent investigation, along with information from the autopsy, revealed that the man suffered from penile carcinoma, thus death was attributed to exsanguination from an ulcerated femoral artery in a patient with penile carcinoma.

• Klíčová slova
• Autopsy, Exsanguination, Forensic medicine, Mutilation, Penile carcinoma,
• MeSH
• arteria femoralis patologie   MeSH
• exsanguinace etiologie   MeSH
• lidé MeSH
• nádory penisu patologie   MeSH
• náhlá smrt etiologie   MeSH
• nekróza MeSH
• senioři MeSH
• spinocelulární karcinom patologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

BACKGROUND: Invasive penile cancer is a rare disease with an approximately 22 000 cases per year. The incidence is higher in less developed countries, where penile cancer can account for up to 10% of cancers among men in some parts of Africa, South America, and Asia. OBJECTIVE: To describe the human papillomavirus (HPV) DNA prevalence, HPV type distribution, and detection of markers of viral activity (ie, E6*I mRNA and p16(INK4a)) in a series of invasive penile cancers and penile high-grade squamous intraepithelial lesions (HGSILs) from 25 countries. A total of 85 penile HGSILs and 1010 penile invasive cancers diagnosed from 1983 to 2011 were included. DESIGN, SETTING, AND PARTICIPANTS: After histopathologic evaluation of formalin-fixed paraffin-embedded samples, HPV DNA detection and genotyping were performed using the SPF-10/DEIA/LiPA25 system, v.1 (Laboratory Biomedical Products, Rijswijk, The Netherlands). HPV DNA-positive cases were additionally tested for oncogene E6*I mRNA and all cases for p16(INK4a) expression, a surrogate marker of oncogenic HPV activity. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: HPV DNA prevalence and type distributions were estimated. RESULTS AND LIMITATIONS: HPV DNA was detected in 33.1% of penile cancers (95% confidence interval [CI], 30.2-36.1) and in 87.1% of HGSILs (95% CI, 78.0-93.4). The warty-basaloid histologic subtype showed the highest HPV DNA prevalence. Among cancers, statistically significant differences in prevalence were observed only by geographic region and not by period or by age at diagnosis. HPV16 was the most frequent HPV type detected in both HPV-positive cancers (68.7%) and HGSILs (79.6%). HPV6 was the second most common type in invasive cancers (3.7%). The p16(INK4a) upregulation and mRNA detection in addition to HPV DNA positivity were observed in 69.3% of HGSILs, and at least one of these HPV activity markers was detected in 85.3% of cases. In penile cancers, these figures were 22.0% and 27.1%, respectively. CONCLUSIONS: About a third to a fourth of penile cancers were related to HPV when considering HPV DNA detection alone or adding an HPV activity marker, respectively. The observed HPV type distribution reinforces the potential benefit of current and new HPV vaccines in the reduction of HPV-related penile neoplastic lesions. PATIENT SUMMARY: About one-third to one-quarter of penile cancers were related to human papillomavirus (HPV). The observed HPV type distribution reinforces the potential benefit of current and new HPV vaccines to prevent HPV-related penile neoplastic lesions.

• Klíčová slova
• DNA, Human papillomavirus, Penile cancer, Vaccine, mRNA, p16,
• MeSH
• DNA virů analýza   MeSH
• genotyp MeSH
• infekce papilomavirem komplikace   virologie   MeSH
• inhibitor p16 cyklin-dependentní kinasy genetika   metabolismus   MeSH
• karcinom virologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lidský papilomavirus 16 genetika   izolace a purifikace   MeSH
• lidský papilomavirus 6 genetika   izolace a purifikace   MeSH
• nádory penisu patologie   virologie   MeSH
• průřezové studie MeSH
• retrospektivní studie MeSH
• RNA virová analýza   MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Afrika MeSH
• Asie MeSH
• Evropa MeSH
• Latinská Amerika MeSH
• Oceánie MeSH
• Severní Amerika MeSH
• Názvy látek
• DNA virů MeSH
• inhibitor p16 cyklin-dependentní kinasy MeSH
• RNA virová MeSH

Surgical implantation of an inflatable penile prosthesis (IPP) remains the gold-standard treatment for severe erectile dysfunction. The ideal surgical technique requires a thorough understanding of the relevant anatomy. This includes anatomic considerations related to, but not limited to, dissection and exposure of penoscrotal fasciae and tissues, corporal configuration, and abdominal structures. Insights obtained from pre-dissected anatomic specimens can obviate urethral injury, nerve damage, corporal perforation, inappropriate sizing, crossover, or implant malposition. We present penile implant-specific anatomic dissections and topographic landmarks identified over the last decade in the course of surgical training programs provided for IPP implantation.

• MeSH
• erektilní dysfunkce * chirurgie   MeSH
• implantace penilní protézy * metody   MeSH
• lidé MeSH
• penilní protézy * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE OF REVIEW: Penile cancer is a rare disease with significant morbidity. Because of the low volume of cases, it has been suggested that its treatment should be centralized in order to improve outcomes through better management of both the primary tumor and distant disease. We reviewed and summarized the most relevant recent publications regarding centralization of penile cancer management. RECENT FINDINGS: Management of penile cancer in academic and supra-regional centers was associated with better survival outcomes. Moreover, reports from population-based studies showed more adherence to guidelines recommendations in academic centers with higher utilization of organ sparing treatments and invasive inguinal lymph node staging. SUMMARY: The optimal management of penile cancer remains a major therapeutic challenge. Patients with invasive tumors are less adequately managed in lower volume nonspecialized centers. The data convincingly support efforts to centralize penile cancer care and to promote the development of centers of expertise in order to achieve the best possible outcomes for each patient.

• MeSH
• léčba šetřící orgány MeSH
• lidé MeSH
• lymfadenektomie MeSH
• lymfatické uzliny patologie   MeSH
• nádory penisu patologie   terapie   MeSH
• staging nádorů MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• systematický přehled MeSH

BACKGROUND: Penile cancer patients with advanced metastatic disease in the inguinal region present a therapeutic challenge. This study assesses the long-term viability of tensor fascia lata (TFL) flap for inguinal reconstruction after inguinal lymphadenectomy in metastatic penile cancer patients. MATERIAL AND METHODS: We herein report eight cases of advanced penile cancer utilizing a TFL flap for reconstructing defects in the inguinal region. Demographic characteristics, perioperative findings and outcome of the patients were evaluated. RESULTS: Patients were followed up for 1-35 months. The mean age of patients included in this study was 58.75 years. Six out of eight patients had a favorable prognosis. The strong vascularity of the TFL flap enables excellent coverage, which can reduce the rate of ischemia and necrosis of the flap. No serious complications occurred in all cases during the perioperative period. One patient developed partial flap necrosis, which required debridement, whereas one patient underwent distal wound dehiscence which resolved with routine wound care. CONCLUSIONS: Our experience demonstrates the versatility and effectiveness of the TFL flap in addressing reconstruction of defects following inguinal lymph node dissection among patients with advanced penile cancer.

• Klíčová slova
• advanced penile cancer, inguinal lymph node dissection, tensor fascia lata flap,
• MeSH
• chirurgické laloky * MeSH
• dospělí MeSH
• fascia lata transplantace   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfadenektomie MeSH
• nádory penisu * chirurgie   MeSH
• senioři MeSH
• zákroky plastické chirurgie * metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

AIMS: Stratified mucin-producing intra-epithelial lesion (SMILE) and invasive stratified mucin-producing carcinoma (ISMC) are recently described cervical and penile lesions. We report an unusual case of mixed variant of penile squamous cell carcinomas with warty, usual and mucoepidermoid SMILE/ISMC features. METHODS AND RESULTS: A 62-year-old Japanese man had a glans penis lesion of one-and-a-half years' duration, suggesting malignancy. Partial penectomy and left inguinal lymphadenectomy were performed. Pathological evaluation revealed a mixed squamous cell carcinoma with warty, mucinous and usual features. The mucinous component resembled mucoepidermoid carcinoma (MEC) and SMILE/ISMC. Glandular differentiation was absent. All the diverse tumour components were negative for p16, which was confirmed by negative human papillomavirus (HPV) genotyping. The mucinous component was diffusely positive for cytokeratin 7 and largely negative for cytokeratin 5 and p63. Fluorescence in-situ hybridisation did not detect rearrangement in the MAML2 or EWSR1 genes. The tumour was pathological stage pT2, pN1 (AJCC prognostic stage group IIIA) and was disease-free 26 months after surgery. CONCLUSIONS: The lack of glands in the mucinous areas suggested that MEC should be separated from adenosquamous carcinoma (ASC). Penile SMILE/ISMC may occur without dependence upon HPV status. Further studies will be necessary to determine the pathogenesis and definition of penile SMILE/ISMC, the presence of true MEC arising from the glans penis and the clinicopathological differences of penile ASC, MEC and SMILE/ISMC. Herein, we refer to the SMILE-like penile lesion as 'mucinous penile intra-epithelial neoplasia'.

• Klíčová slova
• adenosquamous carcinoma, invasive stratified mucin-producing carcinoma, mucoepidermoid carcinoma, penile cancer, penile intraepithelial neoplasia, stratified mucin-producing intra-epithelial lesion, warty carcinoma,
• MeSH
• lidé středního věku MeSH
• lidé MeSH
• mukoepidermoidní karcinom patologie   MeSH
• nádory komplexní a smíšené patologie   MeSH
• nádory penisu patologie   MeSH
• spinocelulární karcinom patologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

PURPOSE: To compare Cancer-specific mortality (CSM) in patients with Squamous cell carcinoma (SCC) vs. non-SCC penile cancer, since survival outcomes may differ between histological subtypes. METHODS: Within the Surveillance, Epidemiology and End Results database (2004-2016), penile cancer patients of all stages were identified. Temporal trend analyses, cumulative incidence and Kaplan-Meier plots, multivariable Cox regression and Fine and Gray competing-risks regression analyses tested for CSM differences between non-SCC vs. SCC penile cancer patients. RESULTS: Of 4,120 eligible penile cancer patients, 123 (3%) harbored non-SCC vs. 4,027 (97%) SCC. Of all non-SCC patients, 51 (41%) harbored melanomas, 42 (34%) basal cell carcinomas, 10 (8%) adenocarcinomas, eight (6.5%) skin appendage malignancies, six (5%) epithelial cell neoplasms, two (1.5%) neuroendocrine tumors, two (1.5%) lymphomas, two (1.5%) sarcomas. Stage at presentation differed between non-SCC vs. SCC. In temporal trend analyses, non-SCC diagnoses neither decreased nor increased over time (p > 0.05). After stratification according to localized, locally advanced, and metastatic stage, no CSM differences were observed between non-SCC vs. SCC, with 5-year survival rates of 11 vs 11% (p = 0.9) for localized, 33 vs. 37% (p = 0.4) for locally advanced, and 1-year survival rates of 37 vs. 53% (p = 0.9) for metastatic penile cancer, respectively. After propensity score matching for patient and tumor characteristics and additional multivariable adjustment, no CSM differences between non-SCC vs. SCC were observed. CONCLUSION: Non-SCC penile cancer is rare. Although exceptions exist, on average, non-SCC penile cancer has comparable CSM as SCC penile cancer patients, after stratification for localized, locally invasive, and metastatic disease.

• Klíčová slova
• Adenocarcinoma, CSM, Cancer-specific mortality, Melanoma, Penile cancer, SCC, Squamous cell carcinoma, Variant histology,
• MeSH
• adenokarcinom * MeSH
• incidence MeSH
• lidé MeSH
• míra přežití MeSH
• nádory penisu * epidemiologie   MeSH
• spinocelulární karcinom * epidemiologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Interstitial low dose rate brachyther-apy is established organ spar-ing treatment of T1- T2 penile carcinoma. Experience with high-dose rate brachyther-apy is limited in this indication. MATERIALS AND METHODS: Twenty-six patients with early penile carcinoma were treated by high-dose rate brachyther-apy at dose 18 × 3 Gy per fraction twice daily between 2002- 2018 at the Department of Oncology and Radiother-apy, University Hospital in Hradec Kralove. Breast interstitial brachyther-apy template was used for fixation and precise geometry reconstruction of stainless hollow needles. RESULTS: Median follow up was 85 months (range 7- 200 months). Acute reaction usually consisted of grade 2 mucositis that dissolved dur-ing 8 weeks after the treatment. Local recurrence occurred in 6 patients, 5 of them were successfully treated with partial amputation. One patient had a nodal recurrence successfully salvaged by lymphadenectomy. One patient developed necrosis of the glans requir-ing partial amputation. Currently, there are 24 patients alive without signs of dis-ease. One patient died of cardiac comorbidity, one died of duplicate lung cancer. Nineteen patients have a preserved penis (73%), 18 of them sexually active before treatment report satisfactory intercourse. CONCLUSION: Hyperfractionated interstitial high-dose rate brachyther-apy with 18 × 3 Gy per fraction twice daily is a promis-ing method in selected patients with penile carcinoma and deserves further evaluation in a larger prospective study. Key words penile neoplasms -  conservative treatment -  brachyther-apy This work was supported by programm Progres Q40. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 8. 1. 2019 Accepted: 15. 1. 2019.

• Klíčová slova
• or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 8. 1. 2019 Accepted: 15. 1. 2019, penile neoplasms -  conservative treatment -  brachyther­apy This work was supported by programm Progres Q40. The authors declare they have no potential conflicts of interest concerning drugs, products,
• MeSH
• brachyterapie * škodlivé účinky   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory penisu radioterapie   MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: Interstitial low-dose rate brachytherapy (BRT) allows a conservative treatment of T1-T2 penile carcinoma. High-dose rate (HDR) BRT is often considered as a dangerous method for interstitial implants because of higher risk of complications. However, numerous reports suggest that results of HDR-BRT may be comparable to low-dose rate BRT. There are no data available in the literature regarding HDR interstitial BRT for carcinoma of the penis. METHODS AND MATERIALS: Ten patients with early penile carcinoma were treated by interstitial hyperfractionated HDR-BRT at the dose of 18 times 3Gy twice daily between years 2002 and 2009. Breast interstitial BRT template was used for fixation and precise geometry reconstruction of stainless hollow needles. RESULTS: Median followup was 20 months. Our BRT technique and fractionation schedule was well tolerated by all patients. Acute reaction consisted predominantly of penis edema and Grade 2 radiation mucositis that dissolved during 8 weeks after the treatment. We neither observed any postradiation necrosis nor urethral stenosis. The worst late side effects recorded were mild telanagiectasias in the treatment region. At the last followup, all patients were alive without evidence of the tumor and with fully functional organ. CONCLUSIONS: Hyperfractionated interstitial HDR-BRT with 18 times 3 Gy per fraction twice daily is a promising method in selected patients of penile carcinoma and deserves further evaluation in a larger prospective study.

• MeSH
• brachyterapie metody   MeSH
• celková dávka radioterapie MeSH
• dospělí MeSH
• frakcionace dávky záření MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory penisu radioterapie   MeSH
• pilotní projekty MeSH
• senioři MeSH
• spinocelulární karcinom radioterapie   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH