Presentation
Glandular and pseudoglandular tumors of the penile skin are extremely uncommon and can present diagnostic challenges. [ncbi.nlm.nih.gov]
Entire Body System
- Swelling
Swelling Swelling at the end of the penis, especially when the foreskin is constricted, is another possible sign of penile cancer. It may be harder to draw back the foreskin. [cancer.org]
A doctor will examine the skin of the penis carefully and may also feel the lymph nodes to check for swelling. [medicalnewstoday.com]
[…] the shaft or tip of the penis Irregular or growing bluish-brown flat lesions or marks beneath the foreskin or on the penis Reddish, velvety rash beneath the foreskin Small, crusty bumps beneath the foreskin Swollen lymph nodes in the groin Irregular swelling [cancer.net]
Always tell your doctor or specialist nurse if you have any swelling in your feet or legs. The earlier lymphoedema is diagnosed, the easier it is to manage. We have more information on lymphoedema. [macmillan.org.uk]
Penis cancer spreads to the lymph nodes in the groin, leading to swelling and/or pain. Diagnosis A lesion suspicious for penile cancer requires a biopsy. This is a procedure where either a portion or entire lesion is removed for pathologic analysis. [washington.edu]
- Lymphadenopathy
A 59-year-old patient with carcinoma of the penis was referred for therapy of clinically fixed and ulcerated bilateral inguinal lymphadenopathies. [ncbi.nlm.nih.gov]
There was no associated inguinal lymphadenopathy. Biopsy showed invasive, well differentiated squamous cell carcinoma. An inguinal ultrasound was negative for lymphadenopathy. [casereports.bmj.com]
Computed tomographic scan of the pelvis of a 63-year-old man reveals inguinal lymphadenopathy. Excision and testing of the right inguinal lymph node revealed moderately differentiated squamous cell carcinoma. [jaoa.org]
- Surgical Procedure
Circumcision is a surgical procedure to remove the foreskin. Penectomy is when the surgeon may remove part or all of the penis, depending on how far the cancer has spread. [scripps.org]
Of the type of surgical procedures performed, partial penectomy and B/L ILND was the most frequently performed surgical procedure, accounting for 66.66% of cases [Table 2]. Keratinizing SCC was the most common histology (90.59%). [indianjcancer.com]
Glossary Biopsy: A minor surgical procedure to remove a small piece of tissue. This tissue is examined under a microscope in a laboratory. Bladder: A hollow, muscular organ in which urine is stored. [acog.org]
It can be treated with surgical and non-surgical procedures. Lichen sclerosus et atrophicus (Balanitis Xerotica Obliterans; BXO) This is the formation of white lesions which can lead to phimosis in uncircumcised men. [orchid-cancer.org.uk]
We will look at the most commonly used surgical procedures. For early stage penile cancer, excisional surgery can be used. [oncolink.org]
- Fatigue
The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, mouth sores, hair loss, loss of appetite, and diarrhea. [cancer.net]
Rarely painful, constitutional symptoms (fatigue, fever, etc.) may result from chronic infection in the nodes. At clinical presentation, determination should be made of the lesion’s size, location, and depth of involvement. [ucurology.org]
These side effects can include hair loss, mouth sores, loss of appetite, nausea and vomiting, diarrhea, increased chance of infections (due to low white blood cell counts), easy bruising or bleeding (due to low blood platelet counts) and fatigue (due [cancersupportcommunity.org]
Weakness, weight loss, fatigue, and systemic malaise occur secondary to chronic suppuration. On occasion, significant blood loss from the penile lesion, the nodal lesion, or both may occur. Symptoms referable to metastases are rare. 19. SIGNS [slideshare.net]
• Problems with ones emotions such as conflict in a relationship, stress, fatigue and being over anxious. • The treatments for prostate cancer may make one more vulnerable to ED. • Medication for diseases such as high blood pressure, antidepressants [andrologiapertutti.com]
- Asymptomatic
Patients are usually asymptomatic and exhibit a variable clinical presentation, which may be accompanied by indurated and growing papules, and pustule warts or ulcerative tumors. [spandidos-publications.com]
[…] suggest that patients infected with human papillomavirus (HPV) types 16, 18, 31, and 33 may have a predisposition to develop squamous carcinoma in both the penis and the cervix. 5, 6 Men may develop condyloma acuminata from this infection, may be totally asymptomatic [ncbi.nlm.nih.gov]
Case 2 A 28-year-old Chinese man presented with an asymptomatic fusiform, 1.4 × 0.4-cm nodule over the ventral aspect of the prepuce, for a 10-year duration (Figure 2a). His medical history was otherwise unremarkable. [cancerindex.org]
Gastrointestinal
- Nausea
There are effective and readily available medications to address traditional side effects from cancer treatment (such as nausea, diarrhea, constipation and mouth sores.) [cancersupportcommunity.org]
The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, mouth sores, hair loss, loss of appetite, and diarrhea. [cancer.net]
It is also better for your health since taking medication such as Viagra can cause diarrhoea and nausea. Conclusion If you suffering from erectile dysfunction (ED), it is important not to beat yourself up as it is not the end of the world. [andrologiapertutti.com]
- Abdominal Pain
[…] in drawing back the foreskin (phimosis) A rash on the penis A change in the color of the penis or foreskin Symptoms of advanced penile cancer include: A lump (swollen lymph node) in the groin Feeling tired Abdominal pain Pain in the bones Weight loss [nypost.com]
Skin
- Ulcer
The importance of early biopsy is emphasised when ulcerative lesions of the penis do not respond adequately to medical therapy. Different treatment modalities available are reviewed. [ncbi.nlm.nih.gov]
Patients present with a lump or an ulcerative lesion of the penis. Palpation of the groin and physical examination may reveal enlarged inguinal lymph nodes. [amboss.com]
- Eczema
The appearance can be confused with bowenoid papulosis, nummular eczema, psoriasis, and superficial basal cell carcinoma. 13. Invasive carcinoma may occur in about 5% to 33% of cases. Metastasis is extremely rare. [slideshare.net]
- Dermatitis
The diagnosis is often delayed, because penile intraepithelial neoplasia may resemble other conditions such as balanitis, candidiasis, dermatitis and psoriasis. [dermnetnz.org]
- Skin Bleeding
Other symptoms of penile cancer include: itching burning discharge changes in the color of the penis thickening of the penile skin bleeding redness irritation swollen lymph nodes in the groin Call your doctor right away if you’re experiencing any of these [healthline.com]
Psychiatrical
- Suggestibility
We suggest that the rhabdoid phenotype could represent a type of degeneration, or a preliminary stage before apoptosis or cell necrosis, instead of a specific differentiation. [ncbi.nlm.nih.gov]
Neurologic
- Confusion
The glandular components of these lesions can present a confusing appearance, particularly when a large tumor is represented on a small biopsy. [ncbi.nlm.nih.gov]
Brain Cancer Brain cancer can have a wide variety of symptoms including seizures, sleepiness, confusion, and behavioral changes. Not all brain tumors are cancerous, and benign tumors can result in similar symptoms. [webmd.com]
Abstract Bowen's disease, erythroplasia of Queyrat and bowenoid papulosis are uncommon disorders of the anogenital skin that may be confused with a variety of other lesions. [pubmed.ncbi.nlm.nih.gov]
The appearance can be confused with bowenoid papulosis, nummular eczema, psoriasis, and superficial basal cell carcinoma. 13. Invasive carcinoma may occur in about 5% to 33% of cases. Metastasis is extremely rare. [slideshare.net]
The data on high-risk HPVs should not be confused with the incidence figures for genital warts, which are large and readily visible, and are caused by the relatively benign HPV types 6 and 11 [Katelaris et al., 1988]. [circinfo.net]
Urogenital
- Penile Lesion
Figure 1 Preoperative anterior view of the fungating penile lesion. Figure 2 Preoperative anterosuperior view of the fungating penile lesion. Figure 3 Anterosuperior view of the resected penile lesion. [casereports.bmj.com]
METHODS: This was a retrospective histologic analysis of 68 cases of penile SCC. Adjacent lesions were considered to be premalignant lesions. [ncbi.nlm.nih.gov]
Diagnosis A lesion suspicious for penile cancer requires a biopsy. This is a procedure where either a portion or entire lesion is removed for pathologic analysis. [washington.edu]
Cutaneous penile horn: conical and exophytic lesion associated with areas of chronic inflammation. Presentation Around half of presenting patients have had the lesion for six months or more. [patient.info]
Workup
Imaging Metastatic workup should include CXR, bone scan, and CT scan of the abdomen and pelvis. Disseminated disease is present in less than 10% of patients at presentation. [health.am]
Microbiology
- Human Papillomavirus
Human papillomavirus infection was determined by polymerase chain reaction to identify a wide range of virus types. [ncbi.nlm.nih.gov]
Treatment
Carbon dioxide and neodymium:YAG lasers are two modalities that are successful in the treatment of in situ and probably early invasive penile carcinoma. Optimal treatment includes coordination with a urologist if urethral disease is present. [ncbi.nlm.nih.gov]
Prognosis
Several different histological subtypes of penile carcinoma had been described in the last decades, many with different biological behavior and prognosis. [ncbi.nlm.nih.gov]
Prognosis of Cancer of the Penis (Squamous Cell Carcinoma of the Penis) Prognosis depends largely on the level of metastases and invasion. The 5 year survival rate for local invasion in 66% but decreases to 27% with lymph node involvement. [myvmc.com]
Etiology
BACKGROUND: In contrast to vulvar squamous cell carcinoma (SCC), the etiologic factors and precancerous lesions associated with penile carcinoma remain uncertain. [ncbi.nlm.nih.gov]
Etiology Chronic inflammation of the penis Risk factors Phimosis, particularly if left untreated Tobacco use Infections Human papillomavirus ( HPV ) infection, especially type H PV -16 and HPV -18 HIV Precancerous skin lesions (see “Differential diagnoses [amboss.com]
Human papillomavirus, particularly types 16 and 18, plays a role in etiology. Premalignant lesions include erythroplasia of Queyrat, Bowen disease, and bowenoid papulosis. [merckmanuals.com]
Epidemiology
Further research is needed to better understand the epidemiology of penile cancer including the role of HPV. [ncbi.nlm.nih.gov]
Epidemiology Rare type of malignancy in industrialized countries More common in developing countries in Africa, South America, and Asia Peak incidence : 60 years of age References: [1] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Pathophysiology
Pathophysiology Penile cancers usually begin as small lesions on the glans or prepuce. They range from white-grey, irregular exophytic to reddish flat and ulcerated endophytic masses. [emedicine.medscape.com]
Prevention
Previous regional lymphadenectomy did not prevent subsequent development of regional recurrence. This clinical presentation and the literature are discussed. [ncbi.nlm.nih.gov]
Primary prevention, education, and vaccination are important to reduce the occurrence of HPV infection and associated cancers. [nejm.org]
"Penile cancer: Epidemiology, pathogenesis and prevention". World Journal of Urology. 27 (2): 141–150. doi : 10.1007/s00345-008-0302-z. [en.wikipedia.org]