Editing Penile Cancer: Non-squamous Penile Cancer (section)

==Extramammary Paget Disease==
*Appearance
**Erythematous, eczematoid, well-demarcated area
**Cannot be clinically distinguished from erythroplasia of Queyrat, Bowen disease, or carcinoma in situ of the penis
**See Figure
*Clinical presentation
**Local discomfort, pruritus, and occasionally a serosanguineous discharge involving the penis, the scrotum, or even the perianal area
*'''Behaves as a slow-growing intraepithelial adenocarcinoma'''
**With time the cells may become invasive with dermal tumor deposits metastasizing to regional lymph nodes via dermal lymphatics penoscrotal
*'''May be associated with other malignancies of the genitourinary tract, such as prostate, bladder, and renal malignancies and should be evaluated for their presence'''
*'''Management'''
**'''In most cases, only the skin and dermis must be resected with a gross margin of up to 3 cm'''. '''Positive margins may still occur, and frozen sections are recommended to guide the extent of resection.'''
***Patients with a positive surgical margin are at a higher risk for recurrence, and additional resection is advised
**Local skin or scrotal flaps can be used to cover the defects.
**In a minority of cases the tumor may invade deeper structures, necessitating more extensive resection and reconstruction
**If inguinal adenopathy is present, radical node dissection is advised but prognosis is poor