[A CASE OF PENILE CANCER WITH PELVIC LYMPH NODE METASTASIS SUCCESSFULLY TREATED WITH SIMULTANEOUS INGUINAL AND PELVIC...

We report a case of penile cancer with bilateral inguinal and pelvic lymph node metastases in which neoadjuvant chemotherapy (NAC), followed by simultaneous bilateral inguinal and pelvic lymph node dissections achieved curative resection. A 66-year-old man presented with a penile tumor. Computed tomography (CT) revealed bilateral inguinal lymph node metastases and enlargement of the external iliac lymph nodes bilaterally. He underwent total penectomy with fine-needle aspiration cytology, which confirmed squamous cell carcinoma (pT2). Although cytology from both inguinal regions was negative, positron emission tomography/CT demonstrated increased uptake in the bilateral inguinal and external iliac lymph nodes, leading to the diagnosis of nodal metastasis. After four cycles of the Taxol Ifosfamide Cisplatin (TIP) regimen, which was Used as NAC, all lesions egressed. Simultaneous bilateral inguinal and pelvic lymph node dissections were subsequently performed. One metastatic lymph node was located just beneath the inguinal ligament; however, complete excision was achieved through a combined inguinal and pelvic approach. Pathological examination showed no regional lymph node metastasis (ypN0). Imaging and tumor marker assessments revealed that has remained cancer-free for one year postoperatively. In this case, NAC with the TIP regimen effectively enabled curative lymph node dissection and achievement of ypN0 status. NAC may represent a valuable therapeutic option for patients with advanced nodal disease, although it is infrequently used for penile cancer in Japan. Simultaneous inguinal and pelvic lymph node dissections allows for complete clearance beneath the inguinal ligament and may be particularly advantageous in such cases.