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A rare case of verrucous carcinoma of penis in an human immunodeficiency virus- infected patient.

Noronha TM, Girisha BS, Bhat SP, Christy CM, Handattu S, Fernandes MS - Indian J Sex Transm Dis (2015 Jul-Dec)

Bottom Line: Cancer is a significant cause of morbidity and mortality in human immunodeficiency virus-infected subjects.Human papillomavirus DNA by polymerase chain reaction was negative.The patient was started on antiretroviral therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, K. S. Hegde Medical Academy, Deralakatte, Mangalore, Karnataka, India.

ABSTRACT
Cancer is a significant cause of morbidity and mortality in human immunodeficiency virus-infected subjects. Verrucous carcinoma is a peculiarly slow evolving, but relentlessly expanding variant of epidermoid carcinoma that is extremely reluctant to metastasize. A 60-year-old unmarried male patient presented with urethral discharge of 3 weeks duration. Dorsal slit of the prepuce revealed an ulceroproliferative growth measuring 3 cm × 3 cm arising from prepuce and involving glans. Biopsy from the growth in the prepuce showed histopathological features of verrucous carcinoma. Partial amputation of the penis was done. Human papillomavirus DNA by polymerase chain reaction was negative. The patient was started on antiretroviral therapy.

No MeSH data available.


Related in: MedlinePlus

Dorsal slit of the prepuce showing an ulceroproliferative growth arising from prepuce and involving glans
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Figure 1: Dorsal slit of the prepuce showing an ulceroproliferative growth arising from prepuce and involving glans

Mentions: A 60-year-old unmarried male patient presented with complaint of urethral discharge of 3 weeks duration which was yellowish, copious and non-foul smelling. There was no history of burning micturition or fever with chills. He was being treated for multiple pruritic lesions over both upper and lower limbs for 7 months prior to onset of his present complaint. He was an alcoholic and a smoker. He denied history of risk of exposure to sexually transmitted diseases. On local examination there was purulent urethral discharge. Phimosis was present and there was induration of the prepuce. Multiple bilateral inguinal lymph nodes were enlarged, discrete, firm and nontender. The patient was referred to urology where a dorsal slit of the prepuce was done which revealed an ulceroproliferative growth measuring 3 cm × 3 cm arising from prepuce and involving glans [Figure 1]. Carcinoma of penis and condyloma acuminata were considered for differential diagnosis. On investigating, Gram stain of urethral discharge showed pleomorphic gram negative bacilli. Venereal disease research laboratory was nonreactive and enzyme linked immunosorbent assay for HIV was positive. Absolute CD4+ T helper cell count was 29 cells/mm3. Biopsy from the growth in the prepuce showed ulcerated dysplastic keratinized stratified squamous epithelium with hyperkeratosis, acanthosis, and papillomatosis. The tumor cells were well differentiated with numerous keratin pearls [Figure 2a]. The base of the tumor was broad and had pushing border infiltrating the subepithelial stroma and showed dense lymphoplasmacytic infiltrate [Figure 2b]. Features were suggestive of verrucous carcinoma of penis (prepuce) infiltrating the subepithelial connective tissue. Fine needle aspiration cytology of the inguinal lymph nodes showed features consistent with reactive lymphadenitis. Partial amputation of penis was done. Corpora cavernosa and spongiosum, urethra and surgical resected margin were free of tumor. Human papillomavirus DNA by polymerase chain reaction test was negative. Patient was started on antiretroviral therapy.


A rare case of verrucous carcinoma of penis in an human immunodeficiency virus- infected patient.

Noronha TM, Girisha BS, Bhat SP, Christy CM, Handattu S, Fernandes MS - Indian J Sex Transm Dis (2015 Jul-Dec)

Dorsal slit of the prepuce showing an ulceroproliferative growth arising from prepuce and involving glans
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660564&req=5

Figure 1: Dorsal slit of the prepuce showing an ulceroproliferative growth arising from prepuce and involving glans
Mentions: A 60-year-old unmarried male patient presented with complaint of urethral discharge of 3 weeks duration which was yellowish, copious and non-foul smelling. There was no history of burning micturition or fever with chills. He was being treated for multiple pruritic lesions over both upper and lower limbs for 7 months prior to onset of his present complaint. He was an alcoholic and a smoker. He denied history of risk of exposure to sexually transmitted diseases. On local examination there was purulent urethral discharge. Phimosis was present and there was induration of the prepuce. Multiple bilateral inguinal lymph nodes were enlarged, discrete, firm and nontender. The patient was referred to urology where a dorsal slit of the prepuce was done which revealed an ulceroproliferative growth measuring 3 cm × 3 cm arising from prepuce and involving glans [Figure 1]. Carcinoma of penis and condyloma acuminata were considered for differential diagnosis. On investigating, Gram stain of urethral discharge showed pleomorphic gram negative bacilli. Venereal disease research laboratory was nonreactive and enzyme linked immunosorbent assay for HIV was positive. Absolute CD4+ T helper cell count was 29 cells/mm3. Biopsy from the growth in the prepuce showed ulcerated dysplastic keratinized stratified squamous epithelium with hyperkeratosis, acanthosis, and papillomatosis. The tumor cells were well differentiated with numerous keratin pearls [Figure 2a]. The base of the tumor was broad and had pushing border infiltrating the subepithelial stroma and showed dense lymphoplasmacytic infiltrate [Figure 2b]. Features were suggestive of verrucous carcinoma of penis (prepuce) infiltrating the subepithelial connective tissue. Fine needle aspiration cytology of the inguinal lymph nodes showed features consistent with reactive lymphadenitis. Partial amputation of penis was done. Corpora cavernosa and spongiosum, urethra and surgical resected margin were free of tumor. Human papillomavirus DNA by polymerase chain reaction test was negative. Patient was started on antiretroviral therapy.

Bottom Line: Cancer is a significant cause of morbidity and mortality in human immunodeficiency virus-infected subjects.Human papillomavirus DNA by polymerase chain reaction was negative.The patient was started on antiretroviral therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, K. S. Hegde Medical Academy, Deralakatte, Mangalore, Karnataka, India.

ABSTRACT
Cancer is a significant cause of morbidity and mortality in human immunodeficiency virus-infected subjects. Verrucous carcinoma is a peculiarly slow evolving, but relentlessly expanding variant of epidermoid carcinoma that is extremely reluctant to metastasize. A 60-year-old unmarried male patient presented with urethral discharge of 3 weeks duration. Dorsal slit of the prepuce revealed an ulceroproliferative growth measuring 3 cm × 3 cm arising from prepuce and involving glans. Biopsy from the growth in the prepuce showed histopathological features of verrucous carcinoma. Partial amputation of the penis was done. Human papillomavirus DNA by polymerase chain reaction was negative. The patient was started on antiretroviral therapy.

No MeSH data available.


Related in: MedlinePlus