World J Oncol
World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access
Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc
Journal website http://www.wjon.org

Case Report

Volume 3, Number 1, February 2012, pages 37-38


Conservative Therapy in Two Cases of Non-Hodgkin Lymphoma of the Penis: Case Reports With Review of the Literature

Giampaolo Delicatoa, b, Giulio Baffigoa, Daniele Bianchia, Giuseppe Farulloa, Stefano Signorea, Edoardo Tartagliaa, Francesco Corvesea, Vincenzo Ferdinandia

aDeparment of Urology-Santo Eugenio Hospital Rome, Largo Umanesimo, 10 - 00144 Rome, Italy
bCorresponding author: Giampaolo Delicato, Via Benaco 7 - 00199 Rome, Italy

Manuscript accepted for publication December 14, 2011
Short title: Treatment of Lymphoma
doi: https://doi.org/10.4021/wjon438w

Abstract▴Top 

The malignant lymphomas rarely occur in the genito-urinary tract and particularly penis lymphomas are extremely uncommon. Frequently they do not have any specific symptoms and the diagnosis is delayed even in presence of a penis node. In our hospital we observed two patients affected by Non-Hodgkin Lymphoma (NHL), one of them with a primitive disease. Both cases were sexually active men who did not accept a radical surgery. A conservative polichemotherapy treatment by ciclophosphamide, vincristine and prednisone has been proposed and performed for both cases and a complete resolution of disease was demonstrated. At the same time we assessed the erectile function by the IIEF score, before and after treatments.

Keywords: Lymphoma of the penis; Genital localization of lymphoma; Chemotherapy

Introduction▴Top 

The genital localization of lymphomas is actually a rare disease. We observed two patients affected by Non-Hodgkin Lymphoma (NHL); we chose a conservative treatment in order to obtain both a good quality of life and good oncological outcomes. We analysed the results with a review of the literature.

Case Report▴Top 

Over the last 12 months two men (71 years old and 72 years old, respectively) presented with a hard and elastic egg-shaped node of the penis. One of the patients had a history of several recurrences of NHL. We performed an ultrasonography (Fig. 1) with needle biopsy of the lesion in both patients [1] and the pathological examination showed in one case a NHL small cell type and in the other case a NHL mantellar cell type. An abdominal CT scan did not show any evidence of nodal involvement. The two patients were also assessed by the 15 questions-IIEF questionnaire which gave a score of 16 and 18, respectively. So a polichemotherapic treatment by ciclophosphamide, vincristine and prednisone has been decided. We repeated the therapy three times in 40 days. After that we reassessed the two patients by a physical examination and an ultrasonography of the penis. At that moment there was a complete resolution of penile NHL localisation in both patients, though in one of them a leucopenia and splenomegalia occurred and dissuaded from repeating other chemotherapic cycles.

Figure 1.
Click for large image
Figure 1. Ultrasonography of the lesion.

After a follow-up of 4 and 8 months no local disease recurrences occurred.

Both patients did not complain any impairment of erectile function as we observed by the IIEF score which was still 15 in the first patient (16 before treatment) and 16 in the second one (16 before treatment).

Discussion▴Top 

Malignant lymphomas of the penis are rare [2-4] and not associated to specific symptoms or signs [5], even if they could present as small and egg-shaped node [6].

The disease is typical of adults [2], with just one paediatric case in the literature [7]. Surgical removal of these nodes is an easy and effective approach, but it frequently causes esthetical problems and erectile disfunction [8]. So our small experience demonstrated that a conservative treatment is effective both in terms of disease recurrence and functional organ preservation [6, 9].

For these reasons in penile lymphomas a conservative therapy could be considered as the first-choice approach also with a curative goal [10].


References▴Top 
  1. Yao HJ, Ying J, Wang Z, Yao DH, Ren XM, Bao YY. [One case report of primary penile malignant lymphoma (with a review of 24 case reports)]. Zhonghua Nan Ke Xue. 2006;12(6):520-524, 527.
    pubmed
  2. Sow M, Fouda PJ, Nkegoum B, Essame Oyono JL, Garau XS, Emo Malonga E. [Primary lymphomas of the urinary in the urological service of the Yaounde Central Hospital]. Prog Urol. 2011;21(3):198-202.
    pubmed doi
  3. Li YL, Wang QZ, Ding GF, Li LX, Ni Z, Wang XM. [Primary non-Hodgkin's lymphoma of the testis and penis: clinical analysis of 5 cases]. Zhonghua Nan Ke Xue. 2011;17(3):254-256.
    pubmed
  4. Sun J, Medeiros LJ, Lin P, Lu G, Bueso-Ramos CE, You MJ. Plasmablastic lymphoma involving the penis: a previously unreported location of a case with aberrant CD3 expression. Pathology. 2011;43(1):54-57.
    pubmed doi
  5. Gallardo F, Pujol RM, Barranco C, Salar A. Progressive painless swelling of glans penis: uncommon clinical manifestation of systemic non-Hodgkin's lymphoma. Urology. 2009;73(4):929 , e923-925.
    pubmed
  6. Ibarz Servio L, Arzoz Fabregas M, Ruiz Dominguez JM, Batlle Massana M, Mate Sanz JL, Saladie Roig JM. [Primary lymphoma of penis]. Actas Urol Esp. 2009;33(7):826-829.
    pubmed doi
  7. Wei CC, Peng CT, Chiang IP, Wu KH. Primary B cell non-hodgkin lymphoma of the penis in a child. J Pediatr Hematol Oncol. 2006;28(7):479-480.
    pubmed doi
  8. Lindberg LJ, Kvist E, Nielsen SL. [Highly malignant B cell lymphoma as penile tumour]. Ugeskr Laeger. 2009;171(46):3370-3371.
    pubmed
  9. Arena F, di Stefano C, Peracchia G, Barbieri A, Cortellini P. Primary lymphoma of the penis: diagnosis and treatment. Eur Urol. 2001;39(2):232-235.
    pubmed doi
  10. Hamamoto S, Tozawa K, Nishio H, Kawai N, Kohri K. Successful treatment of primary malignant lymphoma of the penis by organ-preserving rituximab-containing chemotherapy. Int J Clin Oncol. 2011;
    pubmed


This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


World Journal of Oncology is published by Elmer Press Inc.

 

Browse  Journals  

     

Journal of clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

Journal of Neurology Research

International Journal of Clinical Pediatrics

 

 

 

 

 

World Journal of Oncology, bimonthly, ISSN 1920-4531 (print), 1920-454X (online), published by Elmer Press Inc.        
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)


This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.wjon.org   editorial contact: editor@wjon.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.