Penile Cancer: Non-squamous Penile Cancer

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  • Non-squamous penile cancer is extremely rare

Basal cell carcinoma[edit | edit source]

  • 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[edit | edit source]

  • 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[edit | edit source]

  • Prone to local recurrence; regional and distant metastases are rare.
  • Superficial lesions can be treated with less radical procedures

Extramammary Paget Disease[edit | edit source]

  • 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[edit | edit source]

Lymphoreticular malignant neoplasm[edit | edit source]

Metastases[edit | edit source]

  • 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[edit | edit source]

  • Wein AJ, Kavoussi LR, Partin AW, Peters CA (eds): CAMPBELL-WALSH UROLOGY, ed 11. Philadelphia, Elsevier, 2015