Posoncological Cutaneous Reconstruction of Penis with Scrotum Flaps about a Case

Authors

  • Humberto Miguel Pontillo Institute of Oncology "Dr. Miguel Pérez Carreño ”, Valencia, Venezuela
  • Jhorbet C. Rodríguez Castillo Institute of Oncology "Dr. Miguel Pérez Carreño ”, Valencia, Venezuela
  • Tolentino Dos Santos

DOI:

https://doi.org/10.31907/2414-2093.2019.05.02

Keywords:

Cancer, penile, HPV, reconstruction and faloplastia.

Abstract

Objective: The penile cancer is a rare entity in the developed countries and its incidence increases in the developing countries, achieving up to 10% of the malignancies in men. There is a crucial association with the HPV, in the same way it relates to inadequate hygiene habits and the phimosis. The objective of the surgical treatment is resection with adequate margins, and the inguinal lymph node dissection when indicated. The restore skin coverage in these lesions is a challenge for the surgeon, as it seeks to achieve a phallus almost normal appearance, and restore the patient's tactile and the erogenous function, with the fewest possible interventions, trying to minimize the psychological trauma. Previously, many of these patients were considered inoperable and were recommended to radiation therapy to cure the injury. The evolution of the plastic surgical techniques using skin or the myocutaneous flaps, have provided the surgeon another option to keep the local oncological control with acceptable morbidity.
Clinical Case: The aim of this paper is to present the case of a 56 years old male patient with diagnostic of squamous cell cancer of the penis stage II, who underwent the penile stripping, with bilateral inguinal lymphadenectomy; and rotation flap reconstruction of the scrotal skin. We found no published paper about the skin reconstruction of penile skin flap from scrotum for cancer patients, hence the importance of this work.

References

Parkin D, Whelan S, Ferlay J, Teppo L, Thomas D, editores. Cancer incidence in five continents. Lyon, France IARC: Scientific Publications; 2002. https://doi.org/10.1002/(sici)10970- 258(20000515)19:93.0.co;2-l

Solsona E, Algaba F, Horenblas S, Pizzocaro G, Windahl T, European Association of Urology. EAU Guidelines on penile cancer. Eur Urol. 2004;46(1):1-8. https://doi.org/10.1016/j.eururo.2004.03.007

Pontillo H, Fernández A, León H. Experiencia de 15 años en el manejo del cáncer de pene. Rev Venez Oncol. 2011;23(1):26- 33. https://doi.org/10.4067/s0718-40262008000200004

Ravizzini G, Wagner M, Borges-Neto S. Positron emission tomography detection of metastatic penile squamous cell carcinoma. J Urol. 2001;165:1633-1634. https://doi.org/10.1016/s0022-5347(05)66372-0

Stevens P, Villagrán R, Candia R, Morales L. Cobertura con colgajo escrotal en desforramiento peneano. A propósito de dos Figure 7: Postoperative 7 days evolution. Mild epidermolysis in resolution. casos. Rev Chil Cir. 2008;60(6):570-574. https://doi.org/10.4067/s0718-40262008000600017

Pontillo H. Fernández A, Herrera V, Gelder O. Reconstrucción de defectos inguinales complejos con colgajo VRAM de pedículo inferior en cáncer de pene avanzado. Rev Venez Oncol. 2011;23(3):184-189. https://doi.org/10.1016/s0213-9251(01)72504-x

Monstrey S, Hoebeke P, Selvaggi G, Ceulemans P, Van Landuyt K, Blondeel, et al. Penile reconstruction: Is the radial forearm flap really the standard technique? Plast Reconstr Surg. 2009;124(2):510-518. https://doi.org/10.1097/prs.0b013e3181aeeb06

Russo P, Horenblas S. Surgical management of penile cancer. En: Russo P, editor. Genitourinary Oncology. 3a edición. Filadelfia: Lippincott; 2006.P.809-817.

Pontillo H, Goitia V, Carmona P, Fernández A. Relación entre los factores clínico-patológicos y enfermedad ganglionar inguinal en cáncer de pene. Rev Venez Oncol. 2103; 25(1):26- 34.

Zanettini L, Fachinelli A, Fonseca G. Traumatic degloving lesión of penile and scrotal skin. International Braz J Urol. 2005;31:262-263. https://doi.org/10.1590/s1677-55382005000300012

Díaz M, López M, Otero R, Gutiérrez D Cabezón MA, García A. Faloplastia mediante colgajo libre microquirúrgico antebraquial radial con dOble tunelización. A propósito de un caso. Cir. Plást. iberolatinoam. 2011;37(2)137-142. https://doi.org/10.4321/s0376-78922011000200005

Castro R, Oliveira A, Favorito L. Utilization of skin flap for reconstruction of the genitalia after an electric burn. International Braz J Urol. 2006;32:68-69.

Brown J, Friyer M. Peno-Scrotal skin losses, repaired by implantaron and free skin grafting. Ann Surg. 1957;145:656-664.

Douglas B. One stage reconstruction for traumatic denudation of the male external genitalia. Ann Surg. 1951;133:889-896.

Fu Q. Repair of necrosis and defects of penile skin with autologous free skin flap. Asian J Androl. 2006;8:741-744.

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Published

2019-12-24

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