Penile cancer: symptoms and diagnosis

Symptoms of penis cancer

The main symptoms of penile cancer are the appearance on the skin of the penis of the tumor, initially small in size and often in the form of a gradually increasing compaction. The tumor can be papillary or have the appearance of a flat, dense formation. As the growth can occur, ulceration of the tumor, while there are bleeding and bleeding, right up to profuse. When infected with ulcers, the detachable gets a sharp fetid odor. The spread of the tumor into the cavernous bodies is initially impeded by the fascia fascia and the white shells, the germination of which leads to vascular invasion and dissemination of the tumor process.

In phimosis, the tumor can remain invisible for a long time, and the main complaint of the patient will be associated with secretion from the preputial sac, possibly purulent. Then, in the foreskin, a compaction is found, sometimes a tumor that extends beyond the zone of narrowing of the foreskin.

The general condition of the patient does not suffer for a long time, but as the tumor grows and especially when metastases appear, the following symptoms of penile cancer appear: the general condition of the patient may worsen, manifested as general weakness, loss of appetite and weight loss, increased fatigue, pain in the area tumor. Less often patients complain of an increase in inguinal lymph nodes, pain in the inguinal areas, rezi with urination, hematuria.

Diagnosis of penile cancer

Diagnosis of penile cancer should be comprehensive and include methods of physical. Instrumental and laboratory examination. The main task is to establish the diagnosis and stage of the tumor process.

[1], [2], [3], [4], [5]

Clinical diagnosis of penile cancer

At clinical examination of the patient it is necessary to estimate the size, localization of a tumor, the degree of infiltration of surrounding tissues. In doing so, palpation of the base of the penis and scrotum, inguinal lymph nodes. Rectal examination allows you to assess the condition of the perineum and pelvic organs.

On examination, a tumor is found on the skin of the penis, which, depending on the stage and type of growth, may look different.

With cancer in situ, the tumor is more often represented by a region of hyperemia located on the inner leaf of the foreskin or on the head of the penis sometimes with a wet surface.

• In stages Ta-1, a tumor in the form of a villous exo- or endophyte neoplasm that does not extend to the spongy body of the head and cavernous bodies.
• At stage T2, the tumor infiltrates the head and, possibly, the cavernous bodies.
• At stage T3 a tumor of considerable size, as a rule, with the decay and infiltration of spongy and cavernous bodies, with the transition to the urethra and / or prostate.
• At stage T4, the tumor spreads to the skin, soft pubic tissue, urethra.

[6], [7]

Laboratory diagnosis of penile cancer

The next stage of the examination should be taking a scraping from the surface of the tumor for a cytological examination of the material. Simultaneously, puncture of enlarged or dense regional lymph nodes is performed. In cases where the tumor is endophytic in nature and the result of a cytological examination of the scraping can not establish an accurate diagnosis, an open biopsy is shown to confirm it, clarify the morphological structure of the tumor and its prevalence.

Instrumental diagnosis of penile cancer

With the help of ultrasound determine the size and depth of invasion of the primary tumor, as well as assess the condition of inguinal and iliac lymph nodes. MRI is usually used in the case of uninformative ultrasound. MRI allows you to get a clear picture of the structures of the penis, enabling you to determine with greater accuracy the degree of tumor invasion. Computer tomography is poorly informative in assessing primary lesions, but is effective enough to detect enlarged inguinal and pelvic lymph nodes.