Penile tumors present a difficult diagnostic and therapeutic issue, mainly because of their psychological implications. The diagnosis may be delayed because many patients tend to disregard early asymptomatic lesions and often seek medical attention at an advanced stage when a conservative surgical approach is no longer feasible.
Among malignant neoplasms of the penis, squamous cell carcinoma (SCC) is the most common.
Verrucous carcinoma, also called Buschke-Löwenstein tumor, is a well-differentiated variant of SCC worthy of special recognition.
Primary SCC may occur at any anatomic site on the penis. It most often occurs on the glans, although it may also develop on the prepuce, both the glans and the prepuce, the coronal sulcus, and the shaft. Invasion of the shaft by a tumor originating from more distant sites may also be observed.
The treatment of penile SCC varies according to the clinical stage. Treatment includes radiation therapy, medical therapy (local and systemic), and surgery, alone or in combination. Laser therapy is also used. Because of the generally limited experience with SCC of the penis, considerable controversy exists as to the best form of treatment, specifically treatment for regional lymph nodes.
SCC of the prostate is a rare malignant epithelial neoplasm arising in the prostate, with squamous differentiation of the neoplastic cells.
The time course for the appearance of squamous differentiation in the carcinoma varies from 3 months to many years (up to 9 y) after therapy.
Grossly, the tumors can be large, measuring up to 6.5 cm in greatest dimension. Cut surfaces are remarkable for a solid, firm, whitish-yellow, white-gray, to gray-tan mass. Central extension, with compression of the prostatic urethra, and local invasion into the bladder, rectum, and seminal vesicle may occur.