Penile Cancer

Aka: Penile Cancer, Malignant Neoplasm of Penis, Invasive Squamous Cell Carcinoma of the Penis, Squamous Cell Carcinoma of Penis, Penile Squamous Cell Carcinoma

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II. Epidemiology

  1. Prevalence: 2-3 per 100,000 (rare)
  2. Incidence: Peaks over age 70 years

III. Pathophysiology

  1. Squamous Cell Carcinoma accounts for 95% of Penile Cancers

IV. Risk Factors

  1. Foreskin (Penile Cancer is almost exclusive to uncircumcised men)
  2. Human Papillomavirus Infection (HPV)
  3. Penile Lichen Sclerosus
  4. Tobacco Abuse
  5. Poor foreskin hygiene
  6. Phimosis

V. Signs

  1. Delay in presentation is common (average delay >6 months from onset)
  2. Early presentation
    1. Painless lump or penile ulcer
  3. Later presentation
    1. Thickened skin and wart-like Penile Growth
    2. Foul discharge may be present
    3. Large exophytic irregular masses may develop

VI. Differential Diagnosis

  1. Giant condyloma

VII. Labs: Biopsy

  1. Biopsy all suspicious lesions

VIII. Management

  1. Early stage Penile Cancer may be treated in similar fashion to Penile Cancer in Situ
  2. Higher stage Penile Cancer (T2 to T4) requires penile amputation for cure

IX. References

  1. Mosconi (2005) Crit Rev Oncol Hematol 53(2): 165-77 [PubMed]
  2. Teichman (2010) Am Fam Physician 81(2): 167-74 [PubMed]
  3. Teichman (2018) Am Fam Physician 97(2): 102-10 [PubMed]

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