Mesenchymal Neoplasm of the Penis: Clinicopathological Analysis of 19 Cases.
Gladell P Paner, Mahul B Amin, Jae Y Ro, John R Srigley, David J Grignon, Donna E Hansel, John D Schwartz, Rafael E Jimenez, Mitual B Amin. University of Chicago Hospital, IL; Cedars-Sinai Medical Center, Los Angeles, CA; Methodist Hospital, Houston, TX; Credit Valley Hospital, Mississauga, ON, Canada; Indiana University School of Medicine, Indianapolis; Cleveland Clinic, OH; William Beaumont Hospital, Royal Oak, MI; Mayo Clinic, Rochester, MN
Background: Primary sarcomas of the penis are extremely rare and clinicopathological features of these tumors are not fully explicated.
Design: We report our experience with 19 primary mesenchymal tumors of the penis.
Results: These included 11 leiomyosarcoma (LMS), 2 epithelioid sarcoma (ES), 2 fibrosarcoma (FS), 1 low grade sarcoma, NOS, 1 angiosarcoma (AS), 1 Kaposi's sarcoma (KS), and 1 glomus tumor. Patients with LMS were 44 – 82 yrs old (mean 61 yrs). The LMSs measured 1.5 – 5 cm (mean 2.6 cm) and included 7 superficial and 4 deep tumors, the latter situated below the tunica albuginea or/and involved the corpus spongiosum. By FNLCC system, LMSs were grade 1 (1), 2 (9), and 3 (1). 1 LMS had focal epithelioid and 1 had focal rhabdoid features. 1 patient with deep grade 2 LMS presented with lung metastasis. Follow-up was available in 8 LMS patients (range 5-144 mos). 1 patient with deep grade 2 LMS had recurrence 24 mos after diagnosis and no evidence of disease (NED) 84 mos after diagnosis. 1 patient with deep grade 2 LMS died of disease (DOD) within 1 yr of diagnosis. 1 patient with deep grade 3 LMS died of other cause 5 mos after diagnosis. 4 patients with superficial grade 2 LMS had NED at 12, 36, 42, and 48 mos follow-up and 1 with superficial grade 1 LMS has NED at 144 mos follow-up. ES occurred in 54 yrs old (proximal type) and 18 yrs old (features of conventional type) that presented as penile ulceration. The 18 yr old ES patient presented with lung metastasis and DOD 5 mos after diagnosis. FS occurred in 70 yrs old (1.6 cm, deep, grade IV) and 74 yrs old (2.5 cm, deep, grade III). Follow-up in 1 showed recurrence 45 mos after diagnosis. The low grade sarcoma occurred in a 51 year old patient as a penile urethral mass and had NED 21 mos after transurethral resection. The AS occurred in 53 years old as deep penile lesion and the KS in 61 yrs old as superficial nodular phase lesion.
Conclusions: 1) Penile sarcomas present with a range of histology and are most commonly LMS. 2) Depending on the histologic subtype tumors maybe associated with poorer prognosis. 3) This series shows that aggressive behavior in penile LMSs occurred only in deep tumors, supporting the prognostic importance of the proposed histoanatomic stage.
Category: Genitourinary (including renal tumors)
Tuesday, March 1, 2011 1:00 PM
Poster Session IV # 93, Tuesday Afternoon