Epidemiology, diagnostic and therapeutic problems for carcinoma of the penis in the regions of Plovdiv, Pazardzhik and Smolyan between 1993 and 2002.

INTRODUCTION: Carcinoma of the penis is a malignant tumour which is uncommon in the male population of the Plovdiv, Pazardzhik and Smolyan regions. Recently however, its occurrence in the clinical practice has been on the increase. In the present study we analyse the incidence of penile carcinoma in these regions and address some problems related to late diagnosing of the condition and its therapy. MATERIAL AND METHODS: The study included fifty one patients newly diagnosed with carcinoma of the penis between 1993 and 2002. The patients were registered in the Plovdiv Oncological Centre database. The available data were studied in detail analysing the incidence and mortality rates of the disease. RESULTS: The incidence and mortality rates carried by carcinoma of the penis showed a tendency to simultaneous increase with time--by 0.1355 and 0.0392 per 100000 men per annum, respectively. There is a relatively high number of patients diagnosed with carcinoma of the penis in the stage of invasive local tumor (82.35%). The distribution of the cases by stages is highly unfavourable--over 33% of them were diagnosed very late (stage III and IV). The greatest number of cases (70.59%) received only surgical treatment. The 5-year survival rate of the diagnosed patients is only 58.86%. CONCLUSION: These data about the incidence of the disease and the diagnosis and treatment of penile cancer in the studied regions are indicative of highly unfavourable tendencies for this disease which are reflected in the low efficaciousness of cancer control in the studied localisation.

A rare case of epidermoid cyst of the scrotum with signs of malignization--clinical and morphological features.

Proceeding from the fact that epidermoid cysts of the scrotum are rare and often histologically proven to display evidence of malignization in the underlining epithelium, the authors present a case of scrotal epidermoid cyst from their clinical practice. Epidermoid cysts are given a detailed pathohistologic assessment. The finding was a productive granulomatous inflammation containing multinucleated giant cells of foreign body type in the overlying dermis and intraepidermal "horn pearls" (keratin substance of Queyrat) showing unequivocally signs of malignization of the epidermoid cyst. The authors argue that a histological study should be a must after surgical removal of the cyst as it is the only method to prove beyond any doubt the malignant transformation of the epithelium.