A case of spindle cell carcinoma of the penis

71歳男.尿道口からの出血と排尿困難を主訴に受診した.完全包茎を認めたため背面切開術を施行したところ, 亀頭部に有茎性充実性腫瘤を認めた.生検病理組織診断は非特異的肉芽腫で, 再生検を兼ねた腫瘤摘出術を施行した.病理組織学的診断及び画像診断は陰茎紡錘細胞癌で, 悪性度が高いため陰茎部分摘除術及び両側鼠径リンパ節郭清術を施行した.又, 抗cytokeratin抗体及び抗vimentin抗体を用いた免疫染色と, p53癌抑制遺伝子の免疫染色でも病理組織像と一致した診断であった.術後に軽度のリンパ管炎を認めたが全身状態は良好で, 術後18ヵ月経過現在, 再発を認めていない
Spindle cell carcinoma of the penis is extremely rare. The present case report is the nineth case in the world literature. A 71-year-old man was referred to our institution for examination of a penile tumor that showed non-specific granuloma histopathologically. We performed biopsy and total tumor resection. The histopathological finding showed squamous cell carcinoma with spindle type cells constituting the majority of the tumor, and the switching over from squamous cell carcinoma to spindle cell carcinoma was clearly visible in the histopathological examination. Therefore, we diagnosed this as spindle cell carcinoma of penis and performed partial penectomy with inguinal lymph node dissection. Spindle cell carcinoma is an uncommon variant of squamous cell carcinoma. We report the histopathological findings including the data of p53 immunohistochemical study, and reviewed the eight previous reports of spindle cell carcinoma of the penis.