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Objectives• To describe and report on our variant of penile corporoplasty, the 'double-breasted' corporoplasty, with penoscrotal and infrapubic access not requiring circumcision.• The medicolegal aspects of treatment are also discussed. Patients and Methods• Between February 1995 and October 2012, double-breasted corporoplasty was performed in 93 patients with congenital ventral penile curvature.• Preoperative assessment comprised RigiScan monitoring, prostaglandin E1 injection with photographic documentation and measurement of penile angulation, administration of the International Index of Erectile Function-5 (IIEF-5) questionnaire, and biothesiometry up until 5 years ago when it was substituted with the Genito Sensory Analyser for testing sensitivity.• Dorsal infrapubic access was used in the patients with ventral curvature. After preparation and incision of Colles' fascia, the penis is degloved and double-breasted corporoplasty is performed at the site established at preoperative assessment. The tunica albuginea is prepared, an incision is made, and the cavernous tissue is isolated from the albuginea to obtain two flaps that are then overlaid and sutured asymmetrically with interrupted 2-0 polyglactin 910 (Vicryl ® ) sutures. After the free edge of the albuginea is sutured with a running polyglactin 910 suture, a non-absorbable monofilament and uncoated suture made of polypropylene (Premicron ® ) suture is placed at the point of maximum traction. Results• Complete correction of penile curvature was achieved in 96% of patients; recurrence occurred in 4%.• No major complications were reported, nor were there neurovascular lesions or change in erectile function.• Palpable subcutaneous irregularities at the site of the corporoplasty, without functional or aesthetic impairment, were reported by 35% of patients.• There was no change in the appearance of the penis as circumcision was not performed and the residual scar was barely noticeable as it was hidden in the infrapubic fold.• The corporoplasty technique can adequately restore the patient's psychophysical integrity, making it, from a medicolegal perspective, one of the most reliable procedures in the surgical repair of penile curvature. Conclusions• This original technique is associated with low morbidity, a low recurrence rate and excellent aesthetic results.• The results show that it is safe and effective. When indicated for the surgical treatment of penile curvature, the choice of the technique satisfies the criteria of diligence and prudence for the surgeon's conduct.

Fibrolipomas are a rare subtype of lipomas. We describe a case of a man suffering from subcutaneous penile fibrolipoma, who three months earlier has been submitted to an augmentative phalloplasty due to aesthetic dysmorphophobia. After six months from the excision of the mass, the penile elongation and penile enlargement were stable, and the patient was satisfied with his sexual intercourse and sexual life. To our knowledge, this is the first reported penile subcutaneous fibrolipoma case in the literature. The diagnostics and surgical features of this case are discussed.

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Background: The management of early breast cancer (BC) continues to be challenging because of the heterogeneity of the disease and a limited number of clinical/pathological factors are currently used to guide therapy and prognosis. Recently, p53, a tumor suppressor and BCL2, an antiapoptotic protein have been proposed as additional prognostic markers, although their relationship with conventional parameters and patient prognosis remains uncertain. In particular, there are few data concerning p53 and BCL2 distribution within the molecular BC subtypes, luminal A (LA), luminal B/HER2- (LB/HER2-), luminal B/HER2+ (LB/HER2+), HER2-like (H), and triple negative (TN). Methods: We conducted a retrospective study using immunohistochemistry to evaluate p53 and BCL2 expression in 1099 early BC patients (median age 56 yrs [21-92], N+ 487 [45%]) surgically treated at our Institute between 2000 and 2006 with at least 5 yrs follow-up data. None of the HER2+ patients, included in our series, received trastuzumab in the adjuvant setting. Associations among p53 and BCL2, T, N, G and molecular subtypes were analyzed by multiple correspondence analysis (MCA), while Kaplan-Meier method was applied to determine their impact on disease-free survival (DFS). Results: p53 and BCL2 differently distribute across the 5 molecular subtypes (p-value<0.0001). p53 is highly positive in LB-H+ (38%), H (50%) and TN (33%), conversely, BCL2 is more frequently expressed in LA (71%) and LB-H- (75%) BC. The relationships among bio-pathological factors, analyzed by MCA, confirmed that p53 positive and BCL2 negative BC are located in the quadrant containing more aggressive conventional tumor phenotypes (H and TN subtypes, T3/T4, N+, G3 and presence of relapse). Kaplan-Meier curves identified BCL2 negativity as a significant discriminating factor for DFS (p = 0.024) while p53 does not discriminate BC patients independent of molecular subtypes. Of interest, in the subset of 595 N0 patients p53 positivity and BCL2 negativity were significantly associated to the lack of response to anthracycline (AC ± taxanes) based chemotherapy (p<0.0001). Focusing on the 345 BC who relapsed (132 visceral and 213 non visceral metastases) we observed that visceral metastases are significantly less frequent in LA (30%), LB HER2- (37%) and TN (29%) BC as compared to H (52%) and LB-HER2+ (58%) BC (p = 0.004). Conclusions: Our data indicated that lack of BCL2, in contrast to p53 positivity, appears to be a biomarker related to a more aggressive clinical course across BC molecular subtypes although both biomarkers may affect AC-based chemotherapy response in the subset of N0 patients. Visceral metastases are more frequent in H and LB-HER+ subtypes as compared to the other groups. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-05-16.

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Objective: We describe a new surgical technique for the treatment of penile curvature. In 2012, we developed a new surgical technique for the correction of congenital and acquired penile curvature without circumcision called “track” corporoplasty or Alei II technique Design and Method: For the penile ventral curvature repair an infrapubic transverse dorsal incision is made to correct a ventral curvature or when removing or cutting the plaque in Peyronie’s disease A single 0 non-absorbable synthetic multifilament suture is placed in order to perform a special placation on two parallel lines and therefore called “track”. Laterally to the corporoplasty described, two corporoplasties should be performed along the line that goes from the dorsal neurovascular bundle to the lateral end of the corpus cavernosus at 30° and 60° on the penile sagittal plane. The two corporoplasties should measure 50% at 30° and 25% at 60. Results: Mean age was 43 years for patients with Peyronie’s disease and 31 years for patients with congenital penile deviation. The mean follow-up period was 36 months. No major complications, no circumcision, overall satisfaction 98%. Intraoperative correction of the curvature was achieved in 100%, significant relapse occurred in 2%. Conclusions: This original technique is associated with low morbidity, low recurrence rate and excellent aesthetic results.