We describe the fifth case of mucoepidermoid carcinoma. The patient had penile ulcer with bilateral inguinal and pelvic lymphadenopathy and underwent total penectomy. After antibiotic therapy, the patient began outpatient chemotherapy, but the treatment was discontinued due to his intolerance. The patient died due to infectious complications of the inguinal lymphatic fistula 7 months after the histological diagnosis. Notably, the periurethral area was involved in the anatomopathological evaluation of the excised penis. The penile mucoepidermoid carcinoma was aggressive and the perimeatal region was involved. This case helps demystify the origins and prognosis of this rare case. More reports documenting patient characteristics and their evolution with penile mucoepidermoid carcinoma are needed.
IntroductionSquamous cell carcinoma (SCC) accounts for 95% of the histological types of penile cancer, 1 but other rarer types, such as mucoepidermoid carcinoma (MC), may also affect the penis. The origin of SCC of the penis is usually the scamous epithelial surface, while the MC of the penis does not have a known source. Glans cancer frequently arises from the periurethral glands of Littré, bulbar Cowper, and sweat glands.
2-4The prognosis of penile cancer in its early stages is good. The survival and the risk of metastasis of SCC of the penis are different according to histologic variants. The histological subtypes verrucous, papillary, and verrucoid are low risk, and the usual SCC is intermediate risk and the sarcomatoid or basaloid variants are high risk.5 Although non-SCC types are not classified in risk, their behaviour and prognosis can be ascertained. Basal cell carcinomas are highly curable and have a low potential for metastasis; they are prone to local recurrence, but metastases are rare and the melanomas are aggressive but can be cured if treated early. 6 The adenosquamous carcinoma is locally aggressive, with high histologic grade differentiation at diagnosis and a high rate of lymphovascular invasion.7 It well-known that, generally, metastatic tumours to the penis have a poor prognosis.6 MC of the penis is extremely rare and has a pattern of behavior has not yet been established.We used 4 databases for our analysis (PubMed, Portal de Periódicos da Capes, Lilacs, and SciELO) on February 17, 2014. We searched without filtres and with the intersection of the following MESH terms: "Penile neoplasms" versus "Mucoepidermoid Tumour" or "Carcinoma, Mucoepidermoid" and "Penis" versus "Mucoepidermoid Tumor" or "Carcinoma, Mucoepidermoid." In doing so, we identified 4 cases of primary penile MC (Table 1). This is the fifth case, which adds to the literature and helps delineate the behaviour and origin of this disease.
Case reportOur patient, a 47-year-old had a wound on the penis after circumcision. He sought medical attention 45 days after lesion onset; it was a single lesion, showing ulcerative and infiltrative aspect, about 7 cm, occupying the entire glans and about four-fifths of the distal penile shaft (Fig...