|Year : 2003 | Volume
| Issue : 1 | Page : 64-65
An unusual presentation of penile cancer recurrence
Suresh Bhat1, Muhammed Fassaludeen2, Jacob Cherian1, Appu Thomas1
1 Department of Urology, Medical College, Kottayam, India
2 Department of Medicine, Medical College, Kottayam, India
Department of Urology, Medical College, Kottayam - 686 008
Source of Support: None, Conflict of Interest: None
Keywords: Penis, cancer, recurrence.
|How to cite this article:|
Bhat S, Fassaludeen M, Cherian J, Thomas A. An unusual presentation of penile cancer recurrence. Indian J Urol 2003;20:64-5
| Case Report|| |
A 62-year-old male presented with the greater omenturn extruding through the remains of a short stump of penile shaft. He had undergone partial penectomy for penile cancer four years back. About two months prior to the present problem, an ulcerative lesion developed at the distal end of the penile stump which grew, got infected and later infested with maggots. Examination revealed an elderly male with stable vital signs. There was a left omentocele [Figure - 1]. The omentum was seen coming out just above the corpora cavernosa [Figure - 2]. There were maggots in the penile stump, which were removed using ether. There were enlarged, tender right inguinal lymph nodes, which subsided following a course of antibiotics. The patient had no difficulty in voiding till the omental extrusion.
Routine investigations were within normal limits. A partial omentectomy, suprapubic cystostomy, hernia repair and biopsy of the penile stump were done. Later, emasculation with perineal urethrostomy was performed.
| Comments|| |
Successful local control of carcinoma of the penis by partial penectomy depends on the division of the penis two centimeters proximal to the gross tumor extent. McDougal and associates reported a six percent local recurrence rate after partial penectomy. Autoamputation of the penis by carcinoma has been reported by Hasham. 
Myasis was defined by Zumpt  as the infestation of live human and vertebrate animals with dipterous larvae, which at least for a certain period, feed on the host's dead and living tissues, liquid body substances or ingested food. Many species of fly can cause human myasis.  Naturally occurring cases of myasis in humans with facultative parasites are most commonly seen in young children, in the elderly, in the physically or mentally deranged and in cases of neglect. Natural infestations with these maggots can have beneficial effects or be outright harmful. Necrophagous larvae feed on the dead tissue, cellular debris and the serous drainage of necrotic wounds. Proteolytic enzymes, collagenases, trypsin and chymotrypsin like enzymes are responsible for their actions both good and bad.
Our patient developed recurrence of malignancy in the penile stump, which got infected and infested by maggots. Myasis could have led to the development of the abnormal communication between penis and hernial sac, leading to omental extrusion.
| References|| |
|1.||Hasham AL. Autoamputation of penis from carcinoma. Urology 1975: 5: 244-5. |
|2.||Zumpt F. Myasis in man and animals in the old world. London, Butterworth. 1965; 267. |
|3.||Hall MJR. Smith KGV. Dipters causing myasis in man. Medical insects and arachinids: RD Lane. RW Croskey (eds), London, Chapman and Hall, 1993; 723. |
[Figure - 1], [Figure - 2]