陰茎癌の2例と最近10年間に於ける慈大泌尿器科教室例の統計的観察

Abstract

Case 1. A sixty-seven years old Japanese male w as admitted to the hospital in January, 1963, complaining of a fistula in the prepuse. A thumb tip sized and a little fi nger tip sized enlarged lymphnodes were palpable in the left inguinal region, and an index finger tip sized one in the right side. They were firm but not tender. Amputation of the penis was performed at the p e n o-scrotal junction and removed the lymphnodes two weeks later. The histological report o f the removed penis was of basal cell carcinoma but no metastasis was found in the lymphnodes. The Postoperative c ourse was uneventful and the patient has been in good health without any evidence of reccurrence up to present, about a year and three months after surgery. Case 2. A sixty-two years old Japanese male was admitted to the hospital in August, 1963, complaining of a tumor mass of the penis. Upon admission, a thumb tip sized lym p hnode was noted in the right inguinal region. As the tumor was localized at the tip of the penis, amputation of the penis was performed at about 1 cm proximal to the sulcus coronarius. The enlarged right inguinal node was also removed at the same time. The histological report w as of squamous cell carcinoma and metastasis was noted in the lymphnode. P o stoperatively, irradiation therapies were given with 5, 000r. of 60Coa nd 3000r. of deep X-ray. However, lung metastasis of the tumor was found in sixth month after surg ery, and the patient has still been under our care up to present, about a year after surgery. During the past ten years, eight cases of carcinoma of the penis, including these two cases, were treated at the Jikei University Hospital. The total number a the male outpatierit during the same period was 12, 369, making the incidence of this disease as 0.065 % The ages of the patients varied between thirty-two and sixty-nine (average age fiftynine) and the majority of them were muscle laborer of low economic level. Their chief complaint was mostly a tumor mass of the penis and w as associatted with abnormality in urinary stream in all the cases and local pain in seven of the eight cases. Phimosis was present in five cases; past history of gonorrhoea in two cases and s yphilis in a case. Enlar g ement of the inguinal nodes were seen in six cases on initial examination and two of them were proved to be metastasis. The tumor was mostly orig i n ated in the glans of the penis and six of them were growing ulcerative type. Histologically, o n e of them was basal cell carcinoma but the other seven cases were all squamous cell carcinoma. Total amputatio n of the penis associatted with bilateral inguinal nodes dissection were undergone in three cases and partial amputation of the penis followed by irradiation therapy in two cases. Four cases a r e known to be alive up to present ; three of them are free of tumor but one with metastases in the both lungs. Three cases died in five to eighteen months after surgery. The end result of the remaining two cases are not known .