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Correspondence |

Primary Treatment of Verrucous Carcinoma of the Penis With Fluorouracil, cis-Diamino-dichloro-platinum, and Radiation Therapy

Mark Eliason, MD; Anneli Bowen, MD; Lisa Hazard, MD; Wolfram Samlowski, MD
Arch Dermatol. 2009;145(8):950-952. doi:10.1001/archdermatol.2009.160.
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The standard treatment for a verrucous carcinoma (also known as the giant condyloma of Buschke and Lowenstein) is surgical resection with 2-cm margins.1 For advanced or unresectable penile carcinoma, a number of chemotherapy agents including cisplatin, methotrexate, fluorouracil, and bleomycin have demonstrated modest activity. The Southwest Oncology Group2 performed the largest prospective clinical study of penile carcinoma and found an overall response rate of 32.5% and a complete response rate of 12.5%. It should be noted that this study was performed in patients with regionally advanced or metastatic squamous cell carcinoma (SCC). Based on improvements in chemoradiotherapy of nonpenile epithelial cancers, we evaluated whether this approach could be applied to a patient with advanced penile carcinoma who refused radical surgery.3,4

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Figure 2.

Four months after Mohs surgery. While the graft has taken well, radiation-induced telangiectasia can be seen at the base of the penis.

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Figure 1.

Verrucous carcinoma of the penis. A, At the time of initial consultation, the lesion involved the entirety of the dorsal aspect of the penis. B, Clinical response immediately after completion of chemotherapy and radiation therapy. The white arrowhead points to an area of involuting tumor. The black arrowhead points to the area that later demonstrated recurrent squamous cell carcinoma.

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