Editing Penile Cancer: Non-squamous Penile Cancer

*'''Non-squamous penile cancer is extremely rare'''
==Basal cell carcinoma==
*Frequently encountered on other sun-exposed cutaneous surfaces, it is '''rare on the penis'''
*Treatment is by local excision, which is virtually always curative
==Melanoma==
*Aggressive form of cancer but can be cured if diagnosed and treated with the appropriate surgical treatment at an early stage
**'''Surgery is the primary mode of treatment'''; radiation therapy and chemotherapy are of only adjunctive or palliative benefit
==Sarcoma==
*Prone to local recurrence; regional and distant metastases are rare.
*Superficial lesions can be treated with less radical procedures
==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
==Adenosquamous carcinoma==
==Lymphoreticular malignant neoplasm==
==Metastases==
*Most often represent spread from a clinically obvious existing primary tumor.
*Prognosis is poor, and therapy should be directed toward the primary tumor site histology and local palliation
*'''Priapism is the most frequently encountered sign of metastatic involvement of the penis'''
'''Lymphomatous infiltration of the penis is most likely secondary to diffuse disease'''
==References==
*Wein AJ, Kavoussi LR, Partin AW, Peters CA (eds): CAMPBELL-WALSH UROLOGY, ed 11. Philadelphia, Elsevier, 2015