Penile cancer

Penile cancer (cancer of the penis) is relatively rare. It's more common in elderly and in developing countries. In almost all cases penile cancer is squamous cell carcinoma.

Etiology

• HPV
• Poor hygiene
• Phimosis
• Chronic balanitis

Precancerous lesions

• Bowen disease
• Erythroplasia of Queyrat

Clinical features

• Most commonly in the glans
• Painless lump or ulcerative lesion on penis
• Swollen inguinal lymph node

Diagnosis

• Histological diagnosis
• Excisional biopsy
  • Gold standard

Differential

• Condyloma acuminata
• STD

Treatment

• Partial penectomy
  • If penile length is adequate after surgical excision with a 2 cm margin
• Total penectomy
  • A urethrostomy is made on the perineum
• T1 tumour
  • Hasn’t invaded any of the corpora
  • Surgical excision, laser ablation, radiotherapy
• T2 – T4 or N+ tumour
  • Partial or total penectomy
  • Ipsilateral lymph node dissection (if N+)
  • Adjuvant chemotherapy
• Metastatic disease
  • Palliative chemotherapy