Radical surgery with myocutaneous flap for advanced penile carcinoma: case report

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55歳男性に発症した陰茎扁平上皮癌Stage C (T3N3M0)に対し根治的手術を施行した.鼠径部を含めた広範な皮膚切除および全除精術を施行し,鼠径部および骨盤内リンパ節廓清もおこなった.会陰部に尿道瘻を造設し,両側大腿筋膜張筋筋肉皮弁を作製しこれを用い皮膚欠損部の再建術を施行した.術直後よりペプロマイシン単独投与しその後サイクロフォスファマイド,アドリアシン,シスプラチンを用いた多剤併用化学療法を3コース施行,同時に骨盤部に対し総線量5,000 radの放射線療法をおこなった.術後12ヵ月を経過した現在,再発転移を認めず,歩行起立障害も軽度となったA 55-year-old male with penile epidermoid carcinoma of stage C (T3N3N0) underwent radical surgery. Emasculation with profuse skin removal, including the bilateral groins, and inguinal and pelvic lymphadenectomy were performed. A urethrostomy was created at the perineum, and the skin defect was covered with tensor fascia lata myocutaneous skin flaps. Immediately after recovery from surgery, 3 cycles of chemotherapy with cyclophosphamide, adriamycin and CDDP and radiation (5,000 rad) of the local area were given. The patient is now free from tumor recurrence 12 months after the surgery.