LOCAL RECURRENCE OF PENILE CARCINOMA TREATED BY EXTENSIVE LOCAL RESECTION AND BILATERAL TENSOR FASCIA LATA MYOCUTANEOUS FLAPS: A CASE REPORT

Abstract

A 32-year-old patient with extensive local recurrences of penile carcinoma was successfully treated by a wide local resection and coverage of the tissue defect with bilateral tensor fascia lata myocutaneous flaps. He was previously treated by partial penectomy with bilateral groin dissections. Moreover, he received multiple chemotherapy including bleomycin and supervoltage irradiation to the groin and pelvis. Fifteen months after the first operation, he had extensive local recurrences in the remaining penis, scrotum, groin and perineum. The skin of the groin and lower abdomen showed a slight radiation damage. No definite distant metastasis was observed. An en bloc resection including the penis, scrotum, scrotal contents, skin of the groin, hypogastrium and perineum with bilateral groin and pelvic lymph nodes dissections was performed. Local tissue defect was as large as 26×25cm. Bilateral tensor fascia lata myocutaneous flaps were anteriorly rotated and placed on the tissue defect, leaving a minimal donor defect. Perineal urethrostomy was constructed in the center of the bilateral flaps. Postoperative course was uneventful and he is now working as farmer 3 months after the last operation.
It appears important for urologists to cooperate with plastic surgeons in treating the broad tissue defect or tissue damage due to extensive ablation in cancer surgery, trauma and radiotherapy.