Penile carcinoma C60.-

Rare, mostly highly differentiated spinocellular carcinoma of the penis with varying cornification tendency.

In Europe, the incidence is estimated at 0.1-0.9/100,000 men.

Favouring factors: phimosis (smegma influence); early sexual activity; long term HPV history (recurrent condyloma acuminata); lichen sclerosus et atrophicus.

4th to 7th decade of life.

Mainly dorsal side of the glans penis, sulcus coronarius, prepuce.

Primarily, slow-growing, usually sharply demarcated, irregularly configured, verrucous plaques are seen. Larger tumors (> 0.5 cm) are characterized by rough indurated, irregularly configured, usually ulcerated disintegrating plaques or nodules that bleed easily on mechanical irritation. Penile carcinomas tend to metastasize early to the regional lymph nodes.

Syphilitic primary effect; see below Syphilis acquisita.

• Small tumours (up to about the size of a lens):
  excision with a small safety distance, additionally circumcision for terrain rehabilitation.
• Larger tumours: excision of the tumour by urologists, possibly partial penile amputation. If necessary, additional radiotherapy including the regional lymph node stations (see carcinoma, spinocellular).
• Very large tumours with metastasis in the regional lymph nodes: penis amputation and extirpation of the inguinal and iliac lymph nodes and follow-up radiation (see carcinoma, spinocellular).
• If distant metastasis has already occurred: maximum possible surgical reduction of the tumour mass and subsequent chemotherapy (cisplatin, bleomycin, 5-fluoracil).

The 5-year survival rate for lymph node metastasis depends on the extent of the tumor. In case of unilateral LK infestation 52% of patients survive 5 years, in case of bilateral LK infestation only 27%.