Penile Cancer

Aetiology

Risk factors

  • 5th-6th decade
  • Phimosis (chronic inflammation)
  • Geography - Asia, Africa, South America
  • HPV - types 16 and 18
    • Differentiated - non-HPV
    • Dedifferentiated - HPV related
  • Smoking
  • Immunocompromised patients

Pathophysiology

  • 95% squamous cell carcinoma (skin cancer)
  • Other types: Kaposi's sarcoma, basal cell carcinoma, malignant melanoma, sarcoma
  • Penile intraepithelial neoplasia - rare, pre-cancerous disease of the epidermis of the penis

Clinical presentation

  • Hard, painless lump
  • 10-15% delayed presentation for >1 year due to embarassment, neglect, fear, ignorance
  • Rarely urinary retention or groin mass (inguinal lymphadenopathy)

Investigations

  • Biopsy

Management

  • Prepucial lesions - circumcision
  • Glans lesions - glans resurfacing if superficial, glansectomy if deep
  • More advanced disease - total penile amputation with formation of perineal urethrostomy