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.

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.

• 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).