. Surgery, its principles and practice . eperformed after the mannerdescribed on p. 489. Elephantiasis of thepenis has been fully con-sidered in another chapter(Vol. II, p. 595). Sarcoma.—This is themost serious of the tumorsinvolving the penis. Un-fortunately, the conditionhas made considerable pro-gress before its true nature is suspected. It may occur either primarily or secondarily, the formerbeing the most common. The tumor usually originates in the erectile tissue, grows with greatrapidity, and may reach the size of a fetal head. The surroundingstructures rapidly become involved. In abou
. Surgery, its principles and practice . eperformed after the mannerdescribed on p. 489. Elephantiasis of thepenis has been fully con-sidered in another chapter(Vol. II, p. 595). Sarcoma.—This is themost serious of the tumorsinvolving the penis. Un-fortunately, the conditionhas made considerable pro-gress before its true nature is suspected. It may occur either primarily or secondarily, the formerbeing the most common. The tumor usually originates in the erectile tissue, grows with greatrapidity, and may reach the size of a fetal head. The surroundingstructures rapidly become involved. In about one-half the cases theinguinal glands are affected. The mass finally fungates, and ulcerationwith hemorrhage occurs. Pain is intense, and frequent erections addto the distress of the patient; in the later stage, priapism is not unusual. Death occurs in from ten months to two years. The prognosis is dependent on an early recognition and on promptsurgical intervention. Treatment is operative, and consists of amputation or complete ex-. FiG. 255.—Carcinoma of the Penis. 486 SURGERY OF THE PENIS AND URETHRA. tirpation of the organ. In inoperable cases palliative measures must beresorted to. Carcinoma.—A few cases of medullary carcinoma have been re-ported, developing in young adults, usually as the result of is one of the rarest, and epithelioma one of the commonest, formsof malignant tumors involving the organ. Among the predisposing causes may be mentioned want of cleanli-ness; chronic posthobalanitis; neglected papillomatous growths; phi-mosis, especially in men of advanced years. Not infrequently epithe-lioma has developed as the result of traumatism; it may also originate
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