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Carcinoma penis case discussion.pptx
This document describes the case of a 74-year-old male farmer who presented with inability to pass urine for one day and a lump on the tip of his penis for one year. On examination, he was found to have a hard, nodular lump under complete phimosis involving the entire glans penis. Investigations revealed anemia, renal impairment, urinary tract infection, and biopsy of the growth was positive for carcinoma. The patient underwent partial penectomy and was started on treatment.
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Carcinoma penis case discussion.pptx
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- 2. Demographic data • Mr.N. Chaoba, a 74 year old male • Resident of Phayeng, Imphal, Manipur • A farmer by occupation
- 3. Chief complaints • Presentedwith inability to pass urine since 1 day • Lump at the tip of the penis since 1 year
- 4. History of presentillness • The patient was apparently passing urine normally 6 months back, when the flow of his urine started decreasing and completely stopped since one day
- 5. • There waspast history of inability to retract the prepuce since more than 40 years • The patient also gave history of feeling a hard lump at the tip of the penis since 1 year • It began like a grain on rice, and has now increased to cover the entire tip of the penis
- 6. • There wasno history of nocturia, dysuria, frequency • No history of urethral instrumentation
- 7. Past history • Pasthistory of hypertension since 5 years, on irregular medications • Past history of gouty arthritis • History of appendicectomy 40 years back
- 8. Personal history • Historyof alcohol intake for more than 50 years • History of chewing tobacco for more than 50 years • No history of smoking • Non-vegetarian diet • Normal bowel and sleep habits • No history of allergies
- 9. Family history • Nosignificant family history of cancers or similar illness
- 10. General Examination • Patientconscious, cooperative, orientated to time, place and person • Well nourished • Blood pressure : 130/80 mmHg • Pulse rate : 92/min • Respiratory rate : 24/min • Temperature : afebrile
- 11. Local examination • Completephimosis with a pinhole meatus found • Hard, nodular lump under the foreskin felt • Lump was involving the entire glans penis • Not extending over the shaft of the penis • Scrotum, testes and cord appeared normal • Palpation of the inguinal regions was normal and no lymph nodes were felt
- 12. • Hernial orificesappeared intact • Per rectal examination – normal anal tone, normal anal mucosa, prostate grade II on palpation with firm consistency and no nodules
- 13. Systemic examination • Abdominalexamination : suprapubic tenderness with bladder palpable. Liver palpated 1 cm below the costal margin. Smooth surface, no nodularity or lumps felt. No other palpable organs • Respiratory system : equal air entry on both sides • Cardiovascular system : normal heart sounds heard • Central nervous system : within normal limits
- 14. Investigations • Hb -8.9g/dl • TLC – 7000/c.mm • ESR – 30 mm/hr • Platelets – 1,60,000/c.mm • S.creatinine- 3.2 mg/dl • Blood urea – 85 • Serum total calcium – 10mg/dl • Na, K – wnl • RBS – 125 • ECG - normal
- 15. • GGT –125 • SGOT – 34 • SGPT - 16 • Total bilirubin – 0.3 mg/dl • Total protein – 6.5 g/dl • PT/INR – 12.1 s/ 1.0
- 16. Urinalysis & culture •Color – straw • Appearance – clear • Protein – nil • Ph – 5 • Pus cells – 5-6 • Casts,crystals – nil • RBCs – 1-2 • Ep.cells - occasional • Urine culture – E.coli (100000 CFU/ml)
- 17. • Dorsal slitdone • Growth involving whole glans penis • Biopsy taken • Patient catheterized
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- 22. • Nephrology consultationdone • One unit PRBC transfused • Antibiotics given for UTI
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