A 54-year-old patient presented to our Department in April 2005 with a 2-year history of penile injury.
Physical examination revealed a mass with a lobulated appearance, at the level of the balanopreputial groove, 6x2x2cm in diameter, painless, adhered to deep planes, with prepuce disease.
She did not report any voiding disorders.
Biopsy of this formation was performed under local anesthesia reporting fusocellular carcinoma.
It was decided to perform immediate surgical exploration, performing penile tumorectomy, presumptive superficial tumor type and distal location, with favorable postoperative evolution and externalization.
The anatomopathological result indicated a malignant fusocellular tumor, with extensive necrotic areas and up to 16 mitoses fixed in 10 high-power fields measuring 8x3x2.5cm.
Resection margins in contact with the tumor lesion and foreskin have no particularities.
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Immunohistochemical: high grade leiomyosarcoma with schwannoid histoarchitectural pattern; S100(-), Desmin(+) and Muscle Actin (+++).
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The patient was reoperated fifteen days later, with tomography of the abdomen and pelvis with intravenous contrast without pathological findings and physical examination with signs of tumor persistence, performing total penectomy with perineal meatus.
The pathology report revealed a penectomy piece of 10x 4x 4 cm. with distal cutaneous filling of 4 cm in length, a high-grade malignant fusocellular tumor compatible with deep leiomyosarcomarn.
Proximal, parenchymal and cutaneous margins: tumor-free, no neural or vascular invasion was observed with routine techniques.
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Injury-free ureter
On the fourth postoperative day, the patient evolved favorably and was discharged with control by outpatient clinics.
Currently the patient remains asymptomatic, under urological and oncological control without performing adjuvant treatment, asymptomatic and without signs of local recurrence.
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