ULTRASOUND IN SQUAMOUS-CELL CARCINOMA OF THE PENIS - A USEFUL ADDITION TO CLINICAL STAGING - A COMPARISON OF ULTRASOUND WITH HISTOPATHOLOGY

Objective. As part of the staging procedure in squamous cell carcinoma of the penis, we assessed the role of ultrasound examination, in part icular its role in assessing the extent and the invasion into the corp ora. Methods. From 1988 until 1 999, all patients referred for primary treatment underwent ultrasound assessment with a 7.5 MHz linear array small parts transducer as part of the clinical workup. All ultrasound images were reviewed by one radiologist, without knowledge of the cli nical outcome and were compared with the results obtained at histopath ologic examination. Results. In 16 patients the primary tumor and in 1 patient a recurrent cancer after primary therapy were examined. All t umors were identified as hypoechoic lesions. Ultrasound examination in the region of the glans was not able to differentiate between invasio n of the subepithelial tissue and invasion into the corpus spongiosum, but absence or presence of invasion into the tunica albuginea of the corpus cavernosum was clearly demonstrated. Accurate measurement by ul trasound of maximum tumor thickness was seen in seven of sixteen exami nations. Conclusions. While ultrasound examination is inexpensive and easily done, it is not accurate enough for staging small penile cancer s located at the glans penis. However, for larger tumors ultrasound ca n be a useful addition to physical examination by delineating reliably the anatomic relations of the tumor to structures such as the tunica albuginea, corpus cavernosum, and urethra.