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

Scrotal cancer

Scrotal cancer is a rare cancer. In most cases it's a squamous cell carcinoma. It's related to topical carcinogens: soot, tar, etc. and poor hygiene. It usually presents as a painless, slow growing mass or ulceration. Diagnosis is made by biopsy. The treatment is surgical excision.

Urethral cancer

Urethral cancer is rare. It's more common in females. 70% of cases are squamous cell carcinoma and the remaining are urothelial carcinoma. It usually presents as an obstruction of urine or haematuria. Diagnosis is by biopsy.

Treatment of proximal urethral cancer
- Radical cystourethrectomy + inguinal lymph node removal + urine deviation
Treatment of distal urethral cancer
- Women – surgical resection + radiation
- Men – transurethral resection, amputation, or radiation