ABSTRACT
OBJECTIVES: To develop an international consensus on managing penile cancer patients during the COVID-19 acute waves. A major concern for patients with penile cancer during the coronavirus disease 2019 (COVID-19) pandemic is how the enforced safety measures will affect their disease management. Delays in diagnosis and treatment initiation may have an impact on the extent of the primary lesion as well as the cancer-specific survival because of the development and progression of inguinal lymph node metastases. MATERIALS AND METHODS: A review of the COVID-19 literature was conducted in conjunction with analysis of current international guidelines on the management of penile cancer. Results were presented to an international panel of experts on penile cancer and infection control by a virtual accelerated Delphi process using 4 survey rounds. Consensus opinion was defined as an agreement of ≥80%, which was used to reconfigure management pathways for penile cancer. RESULTS: Limited evidence is available for delaying penile cancer management. The consensus rate of agreement was 100% that penile cancer pathways should be reconfigured, and measures should be developed to prevent perioperative nosocomial transmission of COVID-19. The panel also reached a consensus on several statements aimed at reconfiguring the management of penile cancer patients during the COVID-19 pandemic. CONCLUSIONS: The international consensus panel proposed a framework for the diagnostic and invasive therapeutic procedures for penile cancer within a low-risk environment for COVID-19.
Subject(s)
COVID-19/complications , Delphi Technique , Penile Neoplasms/therapy , Practice Guidelines as Topic/standards , SARS-CoV-2/isolation & purification , Disease Management , Humans , Male , Penile Neoplasms/virologyABSTRACT
Glans resurfacing is a recently described technique in the management of precancerous lesions and superficial invasive tumours of the glans penis as well as cases of indolent persistent lichen sclerosus. The technique is complex and is usually only practiced in specialist centres with combined urological and plastic surgical expertise. Cosmetic and functional results are better than in more extensive penile surgery, such as glansectomy, for such cases, cancer cure and control is comparable. Knowledge of the technique used and the spectrum of disease are vital for appropriate specimen handling and pathological reporting of these complex cases to aid further management and avoid over reporting of positive margins.
Subject(s)
Carcinoma in Situ/surgery , Carcinoma, Squamous Cell/surgery , Penile Neoplasms/surgery , Precancerous Conditions/surgery , Urologic Surgical Procedures, Male/methods , Carcinoma in Situ/pathology , Carcinoma, Squamous Cell/pathology , Humans , Male , Penile Neoplasms/pathology , Precancerous Conditions/pathology , Specimen Handling/methodsABSTRACT
Metastatic malignant melanoma of the urinary bladder is a rare clinical finding suggestive of advanced disease. Only 17 cases have been described in the English literature. We present a case of an 84-year-old male who was referred to the urology department with the incidental finding of bladder metastases on computed tomography (CT) one year following the diagnosis of malignant melanoma of the skin. Herein, we will discuss epidemiology, prognosis, and management options of metastatic malignant melanoma based on literature review.
