RESUMO
OBJECTIVE: To evaluate the predictive factors for relapse in clinically localized squamous cell carcinoma of the penis undergoing surgical treatment. METHODS: Forty-nine patients were diagnosed with cancer of the penis in our Service between 1999 and 2009. In the present study we excluded 18 subjects: 9 due to the presence of palpable adenopathies, 6 due to histological characteristics other than squamous cell carcinoma, two lost to follow-up, and one due to death at the time of diagnosis. Diagnosis was based on physical examination and biopsy findings. The primary lesion was treated by circumcision, partial surgery or total penectomy. Disease relapse was defined by lymph node or metastatic involvement after three months from surgery. Univariate and multivariate analysis were carried out using the chi-squared test and logistic regression to identify the factors involved in tumor relapse. RESULTS: Thirty-one patients were included in the study. Mean follow-up was 36 months (median 29). The histopathological study yielded the following profile: 55% pT1 cases, 32% pT2 cases and 13% pT3 tumors. Regarding histological grade, the distribution was G1: 29%, G2: 32%, G3: 39%. Recurrence and mortality rates were 38.7% and 35.5%, respectively. In the univariate analysis, location of the lesion (p=0.004), type of surgery (p=0.008), tumor stage (p=0.003) and cellular grade (p<0.001)were significantly correlated to disease relapse. In the multivariate analysis, only cellular grade proved statistically significant (p=0.01). CONCLUSION: In our series, only histological grade could be regarded as an independent predictor of tumor relapse.
Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Penianas/patologia , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/cirurgia , Humanos , Estimativa de Kaplan-Meier , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Neoplasias Penianas/cirurgia , Pênis/patologia , Valor Preditivo dos Testes , Análise de SobrevidaRESUMO
We report a case of fibrous pseudotumor of the epididymis as a even more rare location of nodular, fibrous and ossification diffuse proliferation, it may be difficult to distinguish from solid tumors. We also reviewed published report up to date and the differential diagnosis.
Assuntos
Neoplasias Testiculares , Adulto , Humanos , Masculino , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/cirurgiaRESUMO
Aportamos un caso de pseudotumor fibroso del epidídimo como una localización aún más rara de esta proliferación difusa, nodular y osificada que puede ser difícil de diferenciar de los tumores sólidos. También hemos revisado las publicaciones hasta la fecha así como los posibles diagnósticos diferenciales (AU)
We report a case of fibrous pseudotumor of the epididymis as a even more rare location of nodular, fibrous and ossification diffuse proliferation, it may be difficult to distinguish from solid tumors. We also reviewed published report up to date and the differential diagnosis (AU)
Assuntos
Humanos , Masculino , Adulto , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/cirurgia , Diagnóstico Diferencial , Orquiectomia/métodos , Doenças Testiculares/patologia , Doenças Testiculares/cirurgia , Fibrose/patologia , Fibrose/cirurgia , Doenças Testiculares , Escroto/patologia , Epididimo/patologiaRESUMO
OBJETIVO: Evaluar los factores predictores de recidiva del carcinoma epidermoide de pene clínicamente localizado tratado con cirugía.MÉTODOS: 49 pacientes fueron diagnosticados de cáncer de pene en nuestro servicio entre 1999 y 2009. Excluimos 18 pacientes: 9 por adenopatías palpables, 6 por histologías diferentes al epidermoide, 2 por pérdida del seguimiento y 1 por fallecimiento al diagnóstico.El diagnóstico se estableció mediante exploración y biopsia de la lesión. La lesión primaria fue tratada mediante circuncisión, cirugía parcial o penectomía total.Se definió como recidiva la afectación ganglionar o metastásica a partir del tercer mes tras la cirugía.Realizamos un análisis uni y multivariante mediante chi cuadrado y regresión logística para identificar los factores implicados en la recidiva.RESULTADOS: 31 pacientes fueron incluidos en el estudio. El seguimiento medio fue de 36 meses con una mediana de 29.El análisis histopatológico evidenció 55% pT1, 32% pT2 y 13% pT3. El grado histológico fue G1: 29%, G2: 32%, G3: 39%.Las tasas de recidiva y mortalidad fueron 38,7%, y 35,5% respectivamente.En el análisis univariante la localización de la lesión (p=0,004), el tipo de cirugía (p=0,008), el estadio (p=0,003) y el grado celular (p<0,001) se relacionaron de forma estadísticamente significativa con la recidiva.En el análisis multivariante solo el grado celular resultó estadísticamente significativo (p=0,01).CONCLUSIÓN: En nuestra serie, solo el grado histológico puede considerarse factor predictivo independiente de recidiva(AU)
OBJECTIVE: To evaluate the predictive factors for relapse in clinically localized squamous cell car-cinoma of the penis undergoing surgical treatment.METHODS: Forty-nine patients were diagnosed with cancer of the penis in our Service between 1999 and 2009. In the present study we excluded 18 subjects: 9 due to the presence of palpable adenopathies, 6 due to histological characteristics other than squamous cell carcinoma, two lost to follow-up, and one due to death at the time of diagnosis. Diagnosis was based on physical examination and biopsy findings. The primary lesion was treated by circumcision, partial surgery or total penectomy. Disease relapse was defined by lymph node or metastatic involvement after three months from surgery.Univariate and multivariate analysis were carried out using the chi-squared test and logistic regression to identify the factors involved in tumor relapse.RESULTS: Thirty-one patients were included in the study. Mean follow-up was 36 months (median 29). The histopathological study yielded the following profile: 55% pT1 cases, 32% pT2 cases and 13% pT3 tumors. Regarding histological grade, the distribution was G1: 29%, G2: 32%, G3: 39%. Recurrence and mortality rates were 38.7% and 35.5%, respectively.In the univariate analysis, location of the lesion (p=0.004), type of surgery (p=0.008), tumor stage (p=0.003) and cellular grade (p<0.001) were significantly correlated to disease relapse.In the multivariate analysis, only cellular grade proved statistically significant (p=0.01)(AU)