悪性化を認めた巨大尖圭コンジローマの1例

Abstract

58歳男.陰茎腫脹にて受診し, 包皮炎の診断で排膿, 抗生剤治療を繰り返したが発熱が続き入院した.悪性腫瘍の可能性を考慮し生検を実施した結果, 亀頭部では扁平上皮が乳頭状に増殖し, 一部有棘細胞に核周明堤を認め, 尖圭コンジローマの所見を見た.基底細胞に悪性像は認めず, 包皮は瘢痕化した肉芽組織を認めるのみであった.抗生剤治療と連日, 創洗浄を行ったが排膿が続くため包皮切除施行したが改善が見られず, 陰茎切断, 尿路変更術を施行した.術中giant condylomaの診断で悪性像を認めなかったが, 感染巣は海線体内部に浸潤していたため脚部を残し, 全て切除し陰嚢後部に新尿道口を形成した.病理所見より陰茎癌SGC, pT2N0M0, StageIIと診断し, 術後, 放射線療法を実施した.18ヵ月後現在, 再発転移の所見を認めていない

We report a case of giant condyloma with malignant degeneration. A 56-year-old male was referred to our hospital due to a penile infection that was resistant to antibiotic therapy for more than a year. The swelling appeared to be a penile cancer. We suspected malignancy and performed penile biopsies twice; however, the histopathological diagnosis was condyloma acuminatum and malignant findings were absent. We continued the antibiotic therapy for 3 months; however, no improvement was achieved. Therefore, total penectomy and urinary diversion were performed. The pathological diagnosis of the resected tissues was not only condyloma but also squamous cell carcinoma, and cancer cells appeared on the cut surface of the specimens. We added radiation therapy. There was no evidence of recurrence or metastasis at 18 months after surgery.