Carcinoma of the penis overview

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Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Carcinoma of the Penis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Staging
History and Symptoms
Physical Examination
Laboratory Findings
X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Biopsy
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Medical Therapy
Surgery
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Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Joel Gelman, M.D. [2], Director of the Center for Reconstructive Urology and Associate Clinical Professor in the Department of Urology at the University of California,Irvine

Classification

Carcinoma of the penis may be classified according to cell types into several subtypes: squamous cell carcinoma, adenocarcinoma, melanoma, basal cell carcinoma, lymphoma, and sarcoma.

Pathophysiology

On gross pathology, scaly patches or nodules, erythematous, and ulceration are characteristic findings of carcinoma of the penis. On microscopic histopathological analysis, keratinization and intercellular bridges are characteristic findings of carcinoma of the penis.

Epidemiology and Demographics

The incidence of carcinoma of the penisis approximately 1 per 100,000 men in the United States.

Risk Factors

Common risk factors in the development of penile cancer are human papillomavirus, phimosis, poor genital hygiene, not being circumcised, weakened immune system, smoking, and treatment for psoriasis.

Screening

There is insufficient evidence to recommend routine screening for penile cancer.

Causes

Penile cancer is caused by an infection with human papillomavirus.

Differential Diagnosis

Penile cancer must be differentiated from condyloma acuminata, penile intraepithelial neoplasia (PeIN), balanitis xerotica obliterans, buschke-Lowenstein tumour, bowenoid papulosis, and leukoplakia.

Prognosis

Prognosis is generally good, and the 5-year survival rate of patients with penile cancer is approximately 67%. The prognosis varies with the stage of tumor; Stages 0–II have the most favorable prognosis.

Staging

Penile cancer may be classified into several subtypes based on TNM system and UICC staging system.

History and Symptoms

The most common symptoms of penile cencer include non-healing lesion, change in the colour of the penis, redness or irritation of the penis, lump or thickening of the skin on the penis, phimosis, foul-smelling discharge or bleeding from the penis or from underneath the foreskin, itching or burning under the foreskin, swelling of the penis, lump in the groin, and dysuria.

Physical Examination

Common physical examination findings of penile cancer include weight loss, pallor, inguinal lymphadenopathy, non-healing ulcer on the penis, mass on the penis, phimosis, skin induration on the penis, change in the colour of the penis, erythema of the penis, foul-smelling discharge or bleeding from the penis or from underneath the foreskin, and swelling of the penis.

Laboratory Tests

Some patients with penile cancer may have elevated concentration of serum calcium, which is usually suggestive of bone metastases.

X Ray

There are no x-ray findings associated with penile cancer. X-ray may be performed to detect metastases of penile cancer to lungs and bones.

CT

CT scan may be performed to detect metastases of penile cancer to surrounding lymph nodes, liver, lungs and other organs.

MRI

MRI may be helpful in the diagnosis of the extent of the penile cancer. MRI may be performed to detect metastases of penile cancer to brain, spinal cord, and nearby organs and tissues.

Ultrasound

Ultrasound may be helpful in the diagnosis of the extent of the penile cancer.

Other Imaging Findings

There are no other imaging findings associated with penile cancer.

Other Diagnostic Studies

There are no other diagnostic study findings associated with penile cancer.

Biopsy

Biopsy is helpful in the diagnosis of penile cancer.

Medical Therapy

The predominant therapy for penile cancer is surgical resection. Adjunctive chemotherapy, radiation therapy, and biological therapy may be required.

Surgery

Surgery is the mainstay of treatment for penile cancer.

Primary Prevention

Effective measures for the primary prevention of penile cancer include circumcision , good personal hygiene, and safer sexual practices. Gardasil vaccine is recommended for men to prevent HPV infection.

Secondary Prevention

There are no secondary preventive measures available for penile cancer.

References

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