ABSTRACT
INTRODUCTION: Penile intra-epithelial neoplasia (PIN) are precancerous lesions, characterized by architectural and cytological abnormalities of the genital epithelium, from which can arise squamous carcinomas. METHODS: A literature review was performed on the Medline database, considering the articles listed between October 2007 and October 2017 dealing with PIN, using the following keywords "intraepithelial neoplasia" or "Bowen's disease" or "erythroplasia of Queyrat" or "bowenoid papulosis" and "penis ¼. Papers were selected according to their language (English and French) and their relevance. RESULTS: One hundred seventy four articles related to PIN were listed. Twenty-five of them were selected for their relevance. The analysis of the references of these articles identified 6 relevant papers published before October 2007, which were considered for this review based on a total of thirty-one articles. We describe clinical and pathological characteristics of PIN, emphasizing treatment modalities. CONCLUSION: Urologists should distinguish HPV-related and non HPV-related PIN, both of them sharing clinical presentation, but needing different management.
Subject(s)
Bowen's Disease/diagnosis , Carcinoma in Situ/diagnosis , Penile Neoplasms/diagnosis , Bowen's Disease/pathology , Bowen's Disease/therapy , Carcinoma in Situ/pathology , Carcinoma in Situ/therapy , Humans , Male , Papillomavirus Infections/complications , Penile Neoplasms/pathology , Penile Neoplasms/therapy , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Skin Neoplasms/therapySubject(s)
Penile Diseases/pathology , Penis/pathology , Anti-Inflammatory Agents/therapeutic use , Clobetasol/therapeutic use , Debridement , Humans , Hyperplasia , Lasers, Gas/therapeutic use , Male , Penile Diseases/drug therapy , Penile Diseases/surgery , Precancerous Conditions/drug therapy , Precancerous Conditions/pathology , Precancerous Conditions/surgerySubject(s)
Carcinoma, Squamous Cell/virology , Papillomavirus Infections/complications , Penile Neoplasms/virology , Skin Neoplasms/virology , Biopsy , Bowen's Disease/virology , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/surgery , Cryotherapy/methods , Diagnosis, Differential , Electrocoagulation/methods , Humans , Male , Penile Neoplasms/pathology , Penile Neoplasms/surgery , Skin Neoplasms/pathology , Skin Neoplasms/surgery , Treatment OutcomeABSTRACT
Squamous cell carcinomas of the oral cavity and lips consistently have a high incidence (they constitute the fifth most common form of cancer in France) and carry a heavy prognosis, particularly if diagnosed late. According to different studies, between 10 and 80% of such carcinomas occur in a pre-existing or precancerous lesion. The World Health Organisation (WHO) recommends the use of two terms for such lesions: precursor lesions, i.e. histological lesions associated with intraepithelial neoplasia (IEN) and verrucous hyperplasia (VH), frequently resulting clinically in leukoplakia or erythroplakia; "at risk" lesions, which include lichen planus, submucosal oral fibrosis and certain forms of genodermatosis.
Subject(s)
Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/pathology , Lip Neoplasms/diagnosis , Lip Neoplasms/pathology , Mouth Neoplasms/diagnosis , Mouth Neoplasms/pathology , Precancerous Conditions/diagnosis , Precancerous Conditions/pathology , Carcinoma in Situ/diagnosis , Carcinoma in Situ/epidemiology , Carcinoma in Situ/pathology , Carcinoma in Situ/therapy , Carcinoma, Squamous Cell/epidemiology , Carcinoma, Squamous Cell/therapy , Carcinoma, Verrucous/diagnosis , Carcinoma, Verrucous/epidemiology , Carcinoma, Verrucous/pathology , Carcinoma, Verrucous/therapy , Cross-Sectional Studies , Delayed Diagnosis , Erythroplasia/diagnosis , Erythroplasia/epidemiology , Erythroplasia/pathology , Erythroplasia/therapy , Humans , Leukoplakia, Oral/diagnosis , Leukoplakia, Oral/epidemiology , Leukoplakia, Oral/pathology , Leukoplakia, Oral/therapy , Lip/pathology , Lip Neoplasms/epidemiology , Lip Neoplasms/therapy , Mouth Mucosa/pathology , Mouth Neoplasms/epidemiology , Mouth Neoplasms/therapy , Precancerous Conditions/epidemiology , Precancerous Conditions/therapy , Prognosis , Risk FactorsSubject(s)
Buschke-Lowenstein Tumor/pathology , Genital Neoplasms, Male/pathology , Buschke-Lowenstein Tumor/diagnosis , Buschke-Lowenstein Tumor/surgery , Carbon Dioxide , Genital Neoplasms, Male/diagnosis , Genital Neoplasms, Male/surgery , HIV Infections/complications , Humans , Immunocompromised Host , Laser Therapy , Male , PrognosisSubject(s)
Lichen Sclerosus et Atrophicus/pathology , Penile Diseases/pathology , Carcinoma, Squamous Cell/pathology , Child , Circumcision, Male , Diagnosis, Differential , Humans , Lichen Sclerosus et Atrophicus/immunology , Lichen Sclerosus et Atrophicus/therapy , Male , Penile Diseases/immunology , Penile Diseases/therapy , Penile Neoplasms/pathology , Penis/pathology , Precancerous Conditions/pathology , RecurrenceSubject(s)
Genital Diseases, Male/diagnosis , Lichen Planus/diagnosis , Clobetasol/therapeutic use , Diagnosis, Differential , Genital Diseases, Male/complications , Genital Diseases, Male/drug therapy , Glucocorticoids/therapeutic use , Hepatitis C, Chronic/complications , Humans , Lichen Planus/complications , Lichen Planus/drug therapy , MaleSubject(s)
Lymphangitis/diagnosis , Penile Diseases/diagnosis , Penis/pathology , Humans , Male , SclerosisSubject(s)
Genital Diseases, Male , Psoriasis , Adrenal Cortex Hormones/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Arthritis, Psoriatic/epidemiology , Circumcision, Male , Comorbidity , Diagnosis, Differential , Genital Diseases, Male/diagnosis , Genital Diseases, Male/drug therapy , Genital Diseases, Male/epidemiology , Genital Diseases, Male/pathology , Genital Diseases, Male/psychology , Humans , Immunosuppressive Agents/therapeutic use , Male , Nail Diseases/epidemiology , Psoriasis/diagnosis , Psoriasis/drug therapy , Psoriasis/epidemiology , Psoriasis/pathology , Psoriasis/psychology , Quality of Life , Scalp Dermatoses/epidemiologySubject(s)
Carcinoma, Squamous Cell/prevention & control , Circumcision, Male , Penile Diseases/prevention & control , Penile Neoplasms/prevention & control , Sexually Transmitted Diseases/prevention & control , Adult , Balanitis/epidemiology , Balanitis/prevention & control , Carcinoma in Situ/epidemiology , Carcinoma in Situ/prevention & control , Carcinoma, Squamous Cell/epidemiology , Child , Child, Preschool , Circumcision, Male/adverse effects , Circumcision, Male/psychology , Circumcision, Male/statistics & numerical data , Culture , Humans , Infant, Newborn , Lichen Sclerosus et Atrophicus/epidemiology , Lichen Sclerosus et Atrophicus/prevention & control , Male , Penile Diseases/epidemiology , Penile Neoplasms/epidemiology , Phimosis/surgery , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Prospective Studies , Religion , Sexually Transmitted Diseases/epidemiologyABSTRACT
BACKGROUND: Penile biopsy can be useful to establish an accurate diagnosis when managing male genital dermatoses. We investigated the value of genital biopsy by comparing suspected clinical diagnosis with final histologic diagnosis. PATIENTS AND METHOD: We retrospectively examined the clinical file of men with genital dermatoses undergoing genital biopsy. We collected details of age, biopsy site, suspected diagnosis after clinical examination and histologic diagnosis. RESULTS: One hundred and thirty-eight male patients were enrolled in the study. Their mean age was 52 years. Most biopsies (41%) were performed on the glans. Microscopic examination failed to rule out a diagnosis in 14.5% of the cases. It confirmed the clinically suspected diagnosis in 29.7% of cases and ruled out a particular diagnosis from among several clinical hypotheses in 26.8% of cases. The histological diagnosis had not been suspected in 18.1% of cases. DISCUSSION: Penile biopsy has an important role in the diagnosis of penile dermatoses. In our study, in 44.9% of cases, a clinically unsuspected diagnosis was identified or a differential diagnosis was resolved.
Subject(s)
Skin Diseases/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy , Humans , Male , Middle Aged , Penis/pathology , Retrospective Studies , Young AdultSubject(s)
Chronic Pain/etiology , Circumcision, Male/adverse effects , Neuralgia/etiology , Penis , Adult , Humans , MaleABSTRACT
BACKGROUND: Extra-mammary Paget's disease (EMPD) is currently considered a slowly progressing in situ adenocarcinoma. It is much more rarely associated with an invasive underlying adenocarcinoma than in mammary sites, where this association is almost always seen. However, an invasive course is to be feared where EMPD has been progressing for several years. PATIENTS AND METHODS: A 59-year-old man consulted for treatment of scrotal Paget's disease present for over 15 years and treated with topical emollients alone. Two infiltrated areas had recently appeared and their excision led to a diagnosis of invasive Paget's disease at these two points. Metastasis occurred 10 months later and rapidly proved fatal. DISCUSSION: Until now, non-invasive EMPD has been considered a fairly non-aggressive disease due to its indolent progression. However, it is characterised by considerable risk of relapse following surgical excision, regardless of the surgical margin. Despite a good prognosis at the intraepithelial stage, the rising life expectancy of the population means a greater likelihood of an invasive course or of the appearance of an underlying adenocarcinoma, and management of this condition can thus no longer be neglected. The present clinical case underscores the need for closer surveillance of the disease as of the intraepithelial stage.
Subject(s)
Genital Neoplasms, Male , Paget Disease, Extramammary , Scrotum , Fatal Outcome , Genital Neoplasms, Male/pathology , Humans , Male , Middle Aged , Paget Disease, Extramammary/secondaryABSTRACT
BACKGROUND: The treatment of stage I Merkel cell carcinoma (MCC) usually includes wide local excision (WLE) combined with irradiation of the tumor bed (ITB). No randomized study has ever been conducted in MCC. The purpose of this study was to assess the efficacy and safety of prophylactic adjuvant radiotherapy on the regional nodes. PATIENTS AND METHODS: In this randomized open controlled study, patients for a stage I MCC treated by WLE and ITB were randomly assigned to regional adjuvant radiotherapy versus observation. Overall survival (OS) and probability of regional recurrence (PRR) were primary end points. Progression-free survival (PFS) and tolerance of irradiation were secondary end points. RESULTS: Eighty-three patients were included before premature interruption of the trial, due to a drop in the recruitment mainly due to the introduction of the sentinel node dissection in the management of MCC. No significant improvement in OS (P = 0.989) or PFS (P = 0.4) could be demonstrated after regional irradiation, which, however, significantly reduced the PRR (P = 0.007) with 16.7% regional recurrence rate in the observation arm versus 0% in the treatment arm. The treatment was well tolerated. CONCLUSION: The adjuvant regional irradiation significantly decreased the PRR in MCC, but benefit in survival could not be demonstrated.