Editing Penile Cancer: Squamous Penile Cancer (section)

==== <span style="color:#ff0000">Palpable adenopathy</span> ====
* '''Associated with metastasis in 43% of cases, secondary to inflammation in the remainder'''; can consider fine-needle aspiration to differentiate
* '''Lymphadenectomy can be curative''' due to the prolonged locoregional phase before distant dissemination
* '''Inguinal lymphadenectomy is still recommended'''
** '''<span style="color:#ff0000">The superficial lymph node dissection should be bilateral even if adenopathy is unilateral at presentation</span>'''
** '''<span style="color:#ff0000">Complete ilionguinal lymph node dissection (removal of those nodes deep to the fascia lata contained within the femoral triangle as well as the pelvic nodes) is then performed if the superficial nodes are positive at surgery by frozen-section analysis.</span>'''
* '''Exception is verrucous carcinoma, also known as a Buschke-Lowenstein tumor'''
** Unlike penile squamous cell carcinoma, verrucous carcinoma of the penis has a very low likelihood of metastasis.
** Palpable adenopathy in the context of verrucous carcinoma is very likely to be reactive and should be initially observed. Biopsy should be reserved unless the node remains persistently enlarged or grows over time.
** '''Lymphadenectomy in the context of verrucous carcinoma should be reserved for cases of biopsy-proven metastases.'''